Organization
STATMOBILE, INC.
Active
Other names
Alerra Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN A CANALES (PRINCIPAL)
(949) 258-9883
Entity
Organization
Contact information
Practice address
34443 VIA VERDE B, CAPISTRANO BEACH, CA 92624
(949) 258-9883
(949) 281-7707
Mailing address
34443 VIA VERDE B, CAPISTRANO BEACH, CA 92624
(949) 258-9883
(949) 281-7707
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
CA
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2108928
CLIA
CA
01
—
FAC00072258
PORTABLE XRAY REGISTRATION DHS
CA
Enumeration date
09/16/2015
Last updated
05/06/2020
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