| Mobile Vascular Resource Inc. | |
|
7345 Topanga Canyon Blvd Ste 130 Canoga Park CA 91303-1244 | |
| (562) 470-6884 | |
| (888) 646-5861 |
| Full Name | Mobile Vascular Resource Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 7345 Topanga Canyon Blvd Ste 130, Canoga Park, California |
| Authorized Official Name and Position | Winifred Williams (OWNER) |
| Authorized Official Contact | 3234340434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Vascular Resource Inc. 3300 E South St # 301a Lakewood CA 90805-4549 Ph: (562) 470-6884 | Mobile Vascular Resource Inc. 7345 Topanga Canyon Blvd Ste 130 Canoga Park CA 91303-1244 Ph: (562) 470-6884 |
| NPI Number | 1447734249 |
|---|---|
| Provider Enumeration Date | 09/18/2018 |
| Last Update Date | 06/23/2021 |
| Medicare PECOS PAC ID | 3274869979 |
|---|---|
| Medicare Enrollment ID | O20220628000871 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447734249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Winifred E Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982788253 PECOS PAC ID: 2769413947 Enrollment ID: I20050826000830 |
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