Healthcare Provider Details

I. General information

NPI: 1265627624
Provider Name (Legal Business Name): MOBILITY PLUS TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6053 W CENTURY BLVD 9TH FLOOR
LOS ANGELES CA
90045
US

IV. Provider business mailing address

6053 W CENTURY BLVD 9TH FLOOR
LOS ANGELES CA
90045
US

V. Phone/Fax

Practice location:
  • Phone: 310-981-9500
  • Fax: 310-981-9501
Mailing address:
  • Phone: 310-981-9500
  • Fax: 310-981-9501

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 Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIAN ANTHONY SULLIVAN
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 310-981-9500