Healthcare Provider Details
I. General information
NPI: 1851169031
Provider Name (Legal Business Name): CMD ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2023
Last Update Date: 12/18/2023
Certification Date: 12/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1070 HORIZON DR STE N
FAIRFIELD CA
94533-1604
US
IV. Provider business mailing address
1070 HORIZON DR STE N
FAIRFIELD CA
94533-1604
US
V. Phone/Fax
- Phone: 707-344-9896
- Fax:
- Phone: 707-344-9896
- 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:
ROYCE
S
GOREE
Title or Position: CEO
Credential:
Phone: 707-344-9896