Healthcare Provider Details

I. General information

NPI: 1346957644
Provider Name (Legal Business Name): KHOBCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4922 E YALE AVE STE 14
FRESNO CA
93727-1517
US

IV. Provider business mailing address

4922 E YALE AVE STE 14
FRESNO CA
93727-1517
US

V. Phone/Fax

Practice location:
  • Phone: 559-780-6646
  • Fax:
Mailing address:
  • Phone: 559-780-6646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: KEOLA HARRIS
Title or Position: OWNER
Credential: BSHCM
Phone: 559-780-6646