Provider Demographics
NPI:1487765418
Name:MOBILITYGIVER,INC
Entity type:Organization
Organization Name:MOBILITYGIVER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:CRTS
Authorized Official - Phone:714-843-9931
Mailing Address - Street 1:7266 EDINGER AVE STE J
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3500
Mailing Address - Country:US
Mailing Address - Phone:714-843-9931
Mailing Address - Fax:714-843-9936
Practice Address - Street 1:7266 EDINGER AVE
Practice Address - Street 2:SUITE J
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3500
Practice Address - Country:US
Practice Address - Phone:714-843-9931
Practice Address - Fax:714-843-9936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103493332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4743460001Medicare ID - Type UnspecifiedMEDICARE NUMBER