Provider Demographics
NPI:1942428669
Name:AMERICAN MOBILITY PRODUCTS COMPANY
Entity Type:Organization
Organization Name:AMERICAN MOBILITY PRODUCTS COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JESLE
Authorized Official - Middle Name:LLABAN
Authorized Official - Last Name:KUIZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-957-8885
Mailing Address - Street 1:1313 W ROBINHOOD DR
Mailing Address - Street 2:STE A8
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5509
Mailing Address - Country:US
Mailing Address - Phone:209-957-8885
Mailing Address - Fax:209-957-8883
Practice Address - Street 1:1313 W ROBINHOOD DR
Practice Address - Street 2:STE A8
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5509
Practice Address - Country:US
Practice Address - Phone:209-957-8885
Practice Address - Fax:209-957-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43821332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03314FMedicaid
CA5582850001Medicare ID - Type UnspecifiedMEDICARE DMERC D