Provider Demographics
NPI:1508299967
Name:HEALTH MOBILE
Entity Type:Organization
Organization Name:HEALTH MOBILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:REZA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:408-879-0110
Mailing Address - Street 1:2324 MONTPELIER DR STE 3
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1612
Mailing Address - Country:US
Mailing Address - Phone:408-879-0110
Mailing Address - Fax:
Practice Address - Street 1:2324 MONTPELIER DR STE 3
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1612
Practice Address - Country:US
Practice Address - Phone:408-879-0110
Practice Address - Fax:408-244-3995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000669261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health