Organization
MOBILE SWALLOW EVALS, INC.
Active
Organization
MOBILE SWALLOW EVALS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK L. SMITH M.D. (MEDICAL DIRECTOR)
(877) 240-3645
Entity
Organization
Contact information
Practice address
29645 RANCHO CALIF. RD, #101, TEMECULA, CA 92591
(877) 240-3645
(951) 609-3706
Mailing address
27315 JEFFERSON AVE, STE T-9, TEMECULA, CA 92590
(877) 240-3645
(951) 609-3706
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00G01780
CA
235Z00000X
Speech-Language Pathologist
SP5393
CA
247100000X
Radiologic Technologist
435293
CA
261Q00000X
Clinic/Center
Primary
—
CA
Other
Enumeration date
11/18/2009
Last updated
07/21/2022
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