Mobile Medical la LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MOBILE MEDICAL LA LLC

Doing business as

Mobile Medical LA LLC Home Health Agency

Practice address

6818 S la Cienega Blvd
Suite 203
Inglewood, CA 90302-7272

Phone

(310) 645-9009

Fax

(310) 943-2355

NPI assigned

May 24, 2016

Last updated

May 24, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yuliya Yefimov, RN

Title

Ceo

Phone

(310) 507-4305

Specialties & licenses 1

Addresses

Other names 1

• Mobile Medical LA LLC Home Health Agency Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Home infusion therapy

Medicare-enrolled home infusion therapy supplier

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083061626. Details of each certification follow.

• CCN 553178 Home health agency · Active · Details

Home health agency certification: CCN 553178

Legal name

MOBILE MEDICAL LA LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 8, 2019

Last certification

Jan 8, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Feb 29, 2016 in CA

Enrollment address

6818 S la Cienega Blvd
Ste 203
Inglewood, CA 90302-4122
HHA Branch

Listed as

Mobile Medical la LLCCCN 553178 · All quality measures

Ownership

Proprietary

Certified

Jan 8, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Regina R. Berkovich, MD

  • Neurology Physician
  • West Hollywood, CA
  • NPI 1881743748

  Home health agency

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1083061626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6818 S LA CIENEGA BLVD",
            "address_2": "SUITE 203",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903027272",
            "telephone_number": "310-645-9009",
            "fax_number": "310-943-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6818 S LA CIENEGA BLVD",
            "address_2": "SUITE 203",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903027272",
            "telephone_number": "310-645-9009",
            "fax_number": "310-943-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MEDICAL LA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "YEFIMOV",
        "authorized_official_first_name": "YULIYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-507-4305",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Medical LA LLC Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anitha Theresa Mitchell, M.D.
• Beverly A Mitchell
• Bryttany Mitchell
• Channon Mellisa Mitchell
• Tristian E Mitchell, LCSW
• Sarah Jane Mogel, AGACNP-BC
• Hafsa Ahmed Mohamed
• Mohammad Mehdi Mohammadi, DDS
• Zainab Mohammed
• Moka Care Home Health Inc

• Home Health Agency in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.