Provider Demographics
NPI:1336653625
Name:MOBILITY WORKS OF CALIFORNIA, LLC
Entity Type:Organization
Organization Name:MOBILITY WORKS OF CALIFORNIA, LLC
Other - Org Name:MOBILITYWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-200-1379
Mailing Address - Street 1:4199 KINROSS LAKES PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44286-9394
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3383 FITZGERALD RD STE D1
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6820
Practice Address - Country:US
Practice Address - Phone:916-363-8310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-22
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA96527OtherHOME MEDICAL DEVICE RETAIL LICENSE
CA79688OtherHOME MEDICAL DEVICE RETAIL LICENSE
CA93701OtherHOME MEDICAL DEVICE RETAIL LICENSE
CA96429OtherHOME MEDICAL DEVICE RETAIL LICENSE
CA96434OtherHOME MEDICAL DEVICE RETAIL LICENSE
CA96428OtherHOME MEDICAL DEVICE RETAIL LICENSE
CA79689OtherHOME MEDICAL DEVICE RETAIL LICENSE
CA96435OtherHOME MEDICAL DEVICE RETAIL LICENSE
CA96436OtherHOME MEDICAL DEVICE RETAIL LICENSE
CA79693OtherHOME MEDICAL DEVICE RETAIL LICENSE
CA96426OtherHOME MEDICAL DEVICE RETAIL LICENSE