Modesto Mobility Center Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

MODESTO MOBILITY CENTER INC.

Practice address

1025 Lone Palm Ave Ste 5a-B
Modesto, CA 95351-1572

Phone

(209) 577-1069

Fax

(209) 577-5932

NPI assigned

Apr 4, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Dale H Borman

Title

C.F.O.

Phone

(209) 577-1069

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1386987659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 LONE PALM AVE STE 5A-B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953511572",
            "telephone_number": "209-577-1069",
            "fax_number": "209-577-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 LONE PALM AVE STE 5A-B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953511572",
            "telephone_number": "209-577-1069",
            "fax_number": "209-577-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODESTO MOBILITY CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "BORMAN",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "C.F.O.",
        "authorized_official_telephone_number": "209-577-1069",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Modesto, CA
• Providers in Modesto, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.