Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mobile Medical Practitioners

Organization Physician Assistant · NPI 1265854509

Mobile Medical Practitioners is a Physician Assistant in Bala Cynwyd, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2014.

Licensed in
PA
In the registry since
2014

Practice location Address checks out

111 Presidential Blvd Ste 165
Bala Cynwyd, PA 19004-1005
Phone: (215) 701-8153
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA053291 (PA)

Record details

NPI number1265854509
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lance Johnson — Owner · (215) 701-8153
NPI enumeratedJanuary 6, 2014
Last updated in NPPESJanuary 6, 2014
Mailing address111 Presidential Blvd Ste 165, Bala Cynwyd, PA 19004-1005

Other providers in Bala Cynwyd