Provider Demographics
NPI:1376384446
Name:GENTLE MOBILE PHLEBOTOMIST LLC
Entity type:Organization
Organization Name:GENTLE MOBILE PHLEBOTOMIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:AIDE
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MA/CPT 1
Authorized Official - Phone:714-278-2421
Mailing Address - Street 1:8021 9TH ST APT A7
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3598
Mailing Address - Country:US
Mailing Address - Phone:714-278-2421
Mailing Address - Fax:
Practice Address - Street 1:8021 9TH ST APT A7
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3598
Practice Address - Country:US
Practice Address - Phone:714-278-2421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty