Healthcare Provider Details

I. General information

NPI: 1871420455
Provider Name (Legal Business Name): BLUECROSS TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 N LA BREA AVE
INGLEWOOD CA
90302-1214
US

IV. Provider business mailing address

1207 N LA BREA AVE
INGLEWOOD CA
90302-1214
US

V. Phone/Fax

Practice location:
  • Phone: 929-225-5784
  • Fax:
Mailing address:
  • Phone: 929-225-5784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: RAPHEAL ADENIYI OLANIPEKUN
Title or Position: PRESIDENT
Credential:
Phone: 929-225-5784