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Contact Information

RUSSELL G MOBLEY, PA-C
730 NORTH TURNER AVE
APT 2
ONTARIO, CA91764
 Phone: 909-728-1587
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for RUSSELL G MOBLEY · (Male)

NPI # 1073881793
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 12/08/2011
Last updated 12/08/2011 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PA21877
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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