MEDICARE: CALIFORNIA CITY YELLOW CAB COMPANY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	344600000X	Taxi	11035	CA

General Provider Information

NPI Number	:	1871049619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA CITY YELLOW CAB COMPANY

Provider Business Mailing Address
First Line	:	8421 QUEZON AVE
Second Line	:
City	:	CALIFORNIA CITY
State	:	CA
Zip	:	93505-1936
Country	:	US
Telephone Number	:	760-338-3494
Fax Number	:

Provider Business Practice Location Address
First Line	:	8421 QUEZON
Second Line	:
City	:	CALIFORNIA CITY
State	:	CA
Zip	:	93505
Country	:	US
Telephone Number	:	760-338-3494
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	MR. TRAVIS C AGE
Credential	:
Telephone Number	:	760-338-3494

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	08/31/2016

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