Provider Demographics
NPI:1992863013
Name:MOBIN MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MOBIN MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:MILBET
Authorized Official - Middle Name:
Authorized Official - Last Name:SIERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-829-5888
Mailing Address - Street 1:PO BOX 24816
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-0816
Mailing Address - Country:US
Mailing Address - Phone:310-829-5888
Mailing Address - Fax:310-943-2636
Practice Address - Street 1:8929 WILSHIRE BLVD
Practice Address - Street 2:SUITE 415
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1953
Practice Address - Country:US
Practice Address - Phone:310-829-5888
Practice Address - Fax:310-943-2636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61426261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1659316156OtherINDIVIDUAL NPI NUMBER
CAH43613Medicare UPIN
CAW16001Medicare ID - Type Unspecified