Healthcare Provider Details

I. General information

NPI: 1033657879
Provider Name (Legal Business Name): ANGELES TAXI CAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 01/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 E LIVE OAK AVE
ARCADIA CA
91006-5828
US

IV. Provider business mailing address

4125 E LIVE OAK AVE
ARCADIA CA
91006-5828
US

V. Phone/Fax

Practice location:
  • Phone: 909-764-1640
  • Fax:
Mailing address:
  • Phone: 909-764-1640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. ABEL LEYVA
Title or Position: ONWER
Credential: 4383
Phone: 909-764-1640