Healthcare Provider Details

I. General information

NPI: 1093695637
Provider Name (Legal Business Name): CALI EXPRESS MEDICAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/07/2025
Certification Date: 09/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1918 S CHURCH ST APT 22
LODI CA
95240-6291
US

IV. Provider business mailing address

1918 S CHURCH ST APT 22
LODI CA
95240-6291
US

V. Phone/Fax

Practice location:
  • Phone: 209-233-6000
  • Fax:
Mailing address:
  • Phone: 209-233-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: HATEM ALI
Title or Position: OWNER
Credential:
Phone: 209-233-6000