Provider Demographics
NPI:1063167088
Name:PACIFIC MOBILE CARE INC
Entity type:Organization
Organization Name:PACIFIC MOBILE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HELMERS
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:818-857-9457
Mailing Address - Street 1:19120 SCHOENBORN ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4246
Mailing Address - Country:US
Mailing Address - Phone:818-857-9457
Mailing Address - Fax:
Practice Address - Street 1:19120 SCHOENBORN ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4246
Practice Address - Country:US
Practice Address - Phone:818-857-9457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare