Mobile Wound & Diagnostics Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MOBILE WOUND & DIAGNOSTICS INC

Practice address

165 Rowland Way Ste 208
Novato, CA 94945-5055

Phone

(415) 287-0859

Fax

(415) 202-6228

NPI assigned

Dec 17, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Gordon, MD, WCC

Title

President

Phone

(415) 287-0859

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1669010914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 OAKMONT CT",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011235",
            "telephone_number": "404-275-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 ROWLAND WAY STE 208",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455055",
            "telephone_number": "415-287-0859",
            "fax_number": "415-202-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE WOUND & DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-287-0859",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, WCC"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Rachel Michahelles
• Michelle Shariat-Hansen
• Miles Center Road House
• Miles Rae Lane House
• Aleyah Swan Miller
• Amir Momenzadeh
• Monarch Chiropractic
• Monroe Operations, LLC
• Mollie Moore, PA-C, MSPAS, MPH
• Monica Anne Moore, MFT

• Specialist in Novato, CA
• Providers in Novato, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.