Provider Demographics
NPI:1477019818
Name:AMERICAN MOBILE PSYCHIATRIC SERVICES PLLC
Entity Type:Organization
Organization Name:AMERICAN MOBILE PSYCHIATRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D E
Authorized Official - Last Name:TUBAT
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:714-467-6281
Mailing Address - Street 1:10329 W MONTEBELLO AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85307-4313
Mailing Address - Country:US
Mailing Address - Phone:623-824-4489
Mailing Address - Fax:602-786-7796
Practice Address - Street 1:10329 W MONTEBELLO AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85307-4313
Practice Address - Country:US
Practice Address - Phone:623-824-4489
Practice Address - Fax:602-786-7796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty