Provider Demographics
NPI:1215187687
Name:CENTRAL VALLEY MOBILITY
Entity Type:Organization
Organization Name:CENTRAL VALLEY MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-692-2856
Mailing Address - Street 1:30879 CORRAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:COARSEGOLD
Mailing Address - State:CA
Mailing Address - Zip Code:93614
Mailing Address - Country:US
Mailing Address - Phone:559-692-2856
Mailing Address - Fax:559-692-2857
Practice Address - Street 1:30879 CORRAL DR
Practice Address - Street 2:
Practice Address - City:COARSEGOLD
Practice Address - State:CA
Practice Address - Zip Code:93614-9175
Practice Address - Country:US
Practice Address - Phone:559-692-2856
Practice Address - Fax:559-692-2857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies