Provider Demographics
NPI:1750029690
Name:COMMUNITY CARE MOBILE DOCTORS
Entity Type:Organization
Organization Name:COMMUNITY CARE MOBILE DOCTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-810-0185
Mailing Address - Street 1:275 W HOSPITALITY LN STE 314
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3265
Mailing Address - Country:US
Mailing Address - Phone:956-245-2275
Mailing Address - Fax:
Practice Address - Street 1:275 W HOSPITALITY LN STE 314
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3265
Practice Address - Country:US
Practice Address - Phone:956-245-2275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty