Provider Demographics
NPI:1447992144
Name:MOBILE CARE PHYSICIANS GROUP PA
Entity type:Organization
Organization Name:MOBILE CARE PHYSICIANS GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALZALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-952-1412
Mailing Address - Street 1:8270 WOODLAND CENTER BLVD PMB 548
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2401
Mailing Address - Country:US
Mailing Address - Phone:551-227-3669
Mailing Address - Fax:
Practice Address - Street 1:1 GATEWAY CTR STE 2600
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-5323
Practice Address - Country:US
Practice Address - Phone:551-227-3669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty