Provider Demographics
NPI:1588894851
Name:MOBIL CARE DIAGNOSTIC INC.
Entity type:Organization
Organization Name:MOBIL CARE DIAGNOSTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASATUR
Authorized Official - Middle Name:
Authorized Official - Last Name:INJUGHLYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-502-0101
Mailing Address - Street 1:1614 VICTORY BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-2946
Mailing Address - Country:US
Mailing Address - Phone:818-502-0101
Mailing Address - Fax:818-502-9911
Practice Address - Street 1:1614 VICTORY BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-2946
Practice Address - Country:US
Practice Address - Phone:818-502-0101
Practice Address - Fax:818-502-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary DiagnosticsGroup - Multi-Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA65736Medicare UPIN