Provider Demographics
NPI:1528728482
Name:SOCAL MOBILE MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:SOCAL MOBILE MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:SADLER
Authorized Official - Suffix:
Authorized Official - Credentials:CPT1
Authorized Official - Phone:626-388-8067
Mailing Address - Street 1:11762 DE PALMA RD STE 1-C304
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-4010
Mailing Address - Country:US
Mailing Address - Phone:626-388-8067
Mailing Address - Fax:877-319-4970
Practice Address - Street 1:11762 DE PALMA RD STE 1-C304
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-4010
Practice Address - Country:US
Practice Address - Phone:626-388-8067
Practice Address - Fax:877-319-4970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health