Provider Demographics
NPI:1972586071
Name:SUPERIOR MOBILITY, INC.
Entity type:Organization
Organization Name:SUPERIOR MOBILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-755-6480
Mailing Address - Street 1:1950 E 220TH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90810-1651
Mailing Address - Country:US
Mailing Address - Phone:310-755-6480
Mailing Address - Fax:310-212-3120
Practice Address - Street 1:1901 HOLSER WALK
Practice Address - Street 2:SUITE 302
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2633
Practice Address - Country:US
Practice Address - Phone:805-640-1332
Practice Address - Fax:805-604-1334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101318332BC3200X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME02892FMedicaid
CA0230020002Medicare NSC