Provider Demographics
NPI:1275292963
Name:MOBILE CARE PHYSICIANS GROUP PC
Entity Type:Organization
Organization Name:MOBILE CARE PHYSICIANS GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALZALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-433-4607
Mailing Address - Street 1:8270 WOODLAND CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2401
Mailing Address - Country:US
Mailing Address - Phone:630-454-0257
Mailing Address - Fax:
Practice Address - Street 1:755 N BROWN RD
Practice Address - Street 2:STE 200
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043
Practice Address - Country:US
Practice Address - Phone:630-454-0257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care