Healthcare Provider Details

I. General information

NPI: 1568765097
Provider Name (Legal Business Name): RANA LOGISTIC TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2010
Last Update Date: 12/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 GATEWAY DR APT 62
PACIFICA CA
94044-1636
US

IV. Provider business mailing address

423 GATEWAY DR APT 62
PACIFICA CA
94044-1636
US

V. Phone/Fax

Practice location:
  • Phone: 650-333-8471
  • Fax:
Mailing address:
  • Phone: 650-333-8471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number5114
License Number StateCA

VIII. Authorized Official

Name: IBRAHIM BASMA
Title or Position: OWNER
Credential:
Phone: 650-333-8471