Healthcare Provider Details

I. General information

NPI: 1871982900
Provider Name (Legal Business Name): CDS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17035 3/4 CLARK AVE
BELLFLOWER CA
90706-5721
US

IV. Provider business mailing address

17035 3/4 CLARK AVE
BELLFLOWER CA
90706-5721
US

V. Phone/Fax

Practice location:
  • Phone: 562-716-9436
  • Fax:
Mailing address:
  • Phone: 562-716-9436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOEL GUEVARRA DE LUNA
Title or Position: MANAGER
Credential:
Phone: 310-346-2102