NPI 1073881793

Russell G Mobley, PAC

Practitioner Physician Assistant Ontario, CA

Practice location

Address: 730 North Turner Ave APT 2, Ontario, CA 91764
Phone: (909) 728-1587
Mailing address: 730 N Turner Ave APT 2, Ontario, CA 91764-5524

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA21877 (CA)

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Registry record

NPI: 1073881793
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Dec 2011
Record last updated: 8 Dec 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.