Provider Demographics
NPI:1851403620
Name:SENIOR MOBILITY AIDS, INC.
Entity Type:Organization
Organization Name:SENIOR MOBILITY AIDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:LAFAYETTE
Authorized Official - Last Name:NEWSOME
Authorized Official - Suffix:JR
Authorized Official - Credentials:ATP
Authorized Official - Phone:760-599-8800
Mailing Address - Street 1:6965 EL CAMINO REAL # 105-253
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-4100
Mailing Address - Country:US
Mailing Address - Phone:760-599-8800
Mailing Address - Fax:760-599-8844
Practice Address - Street 1:2236 RUTHERFORD RD STE 107
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-8836
Practice Address - Country:US
Practice Address - Phone:760-599-8800
Practice Address - Fax:760-599-8844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103174332B00000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1127530001Medicare ID - Type Unspecified