Healthcare Provider Details

I. General information

NPI: 1548198989
Provider Name (Legal Business Name): CANOPY CARE TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6805 LONDON DR
EUREKA CA
95503-7085
US

IV. Provider business mailing address

6805 LONDON DR
EUREKA CA
95503-7085
US

V. Phone/Fax

Practice location:
  • Phone: 707-498-1900
  • Fax:
Mailing address:
  • Phone: 707-498-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL COBLENTZ
Title or Position: OWNER
Credential:
Phone: 707-498-1900