Provider Demographics
NPI:1326518861
Name:MY MOBILE DOC INC
Entity Type:Organization
Organization Name:MY MOBILE DOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTOC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-996-9332
Mailing Address - Street 1:4295 JURUPA ST STE 116
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-1430
Mailing Address - Country:US
Mailing Address - Phone:909-996-9332
Mailing Address - Fax:
Practice Address - Street 1:4295 JURUPA ST STE 116
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-1430
Practice Address - Country:US
Practice Address - Phone:909-996-9332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management