Healthcare Provider Details

I. General information

NPI: 1841194925
Provider Name (Legal Business Name): ARDALAN FARD HABIBI TRANSPORTATION
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 KYLE CT
LADERA RANCH CA
92694-0202
US

IV. Provider business mailing address

11 KYLE CT
LADERA RANCH CA
92694-0202
US

V. Phone/Fax

Practice location:
  • Phone: 949-432-0063
  • Fax:
Mailing address:
  • Phone: 949-432-0063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: