Healthcare Provider Details
I. General information
NPI: 1801753603
Provider Name (Legal Business Name): INDEPENDENT LIFE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1062 W CITRUS ST
COLTON CA
92324-6809
US
IV. Provider business mailing address
1062 W CITRUS ST
COLTON CA
92324-6809
US
V. Phone/Fax
- Phone: 909-554-9765
- Fax:
- Phone: 909-554-9765
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 342000000X |
| Taxonomy | Transportation Network Company |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 347E00000X |
| Taxonomy | Transportation Broker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ARTHUR
CALLES
Title or Position: OWNER
Credential:
Phone: 909-649-6866