1083122279 NPI number — THE MOBILEYES FOUNDATION

Table of content: (NPI 1083122279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083122279 NPI number — THE MOBILEYES FOUNDATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE MOBILEYES FOUNDATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083122279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13790 COCHISE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APPLE VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92307-6002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-816-7338
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13790 COCHISE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APPLE VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92307-6002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-816-7338
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2018

Additional Information

Authorized Official

Authorized Official Last Name:
ULIBARRI
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
PRESIDENT, CEO, FOUNDER
Authorized Official Telephone Number:
951-837-5357

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  13883 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1457688947 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com