Healthcare Provider Details

I. General information

NPI: 1487518759
Provider Name (Legal Business Name): TAHE MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39491 COZUMEL CT
MURRIETA CA
92563-2552
US

IV. Provider business mailing address

855 WILCOX AVE UNIT 303
LOS ANGELES CA
90038-4611
US

V. Phone/Fax

Practice location:
  • Phone: 619-701-8368
  • Fax:
Mailing address:
  • Phone: 618-741-7167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ALVARO HERNANDEZ
Title or Position: MANAGING PARTNER
Credential:
Phone: 619-701-8368