Provider Demographics
NPI:1811571151
Name:AZ MOBILE MEDICAL LLC
Entity Type:Organization
Organization Name:AZ MOBILE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RCM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOSEFINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUCHANGCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-209-5284
Mailing Address - Street 1:1355 N GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234
Mailing Address - Country:US
Mailing Address - Phone:480-567-3040
Mailing Address - Fax:
Practice Address - Street 1:1355 N GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234
Practice Address - Country:US
Practice Address - Phone:480-567-3040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty