Healthcare Provider Details

I. General information

NPI: 1033036009
Provider Name (Legal Business Name): PRESTIGE TRANSPORT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 WAKE AVE SPC 101
EL CENTRO CA
92243-9653
US

IV. Provider business mailing address

225 WAKE AVE SPC 101
EL CENTRO CA
92243-9653
US

V. Phone/Fax

Practice location:
  • Phone: 760-554-6311
  • Fax:
Mailing address:
  • Phone: 760-554-6311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: JORGE RUIZ
Title or Position: CEO/OWNER
Credential:
Phone: 760-554-6311