Healthcare Provider Details

I. General information

NPI: 1114781903
Provider Name (Legal Business Name): SOCAL RIDE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 02/12/2024
Certification Date: 02/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27416 PINYON ST
MURRIETA CA
92562-4385
US

IV. Provider business mailing address

39683 RANCHWOOD DR
MURRIETA CA
92563-5310
US

V. Phone/Fax

Practice location:
  • Phone: 951-588-4687
  • Fax:
Mailing address:
  • Phone: 951-588-4687
  • 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 Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: SHEREEN & FADYH H ATTIA
Title or Position: CEO
Credential: OWNER
Phone: 951-588-4687