Healthcare Provider Details

I. General information

NPI: 1891517140
Provider Name (Legal Business Name): DHIRAJ DADWAL NEMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17598 BRETTON WOODS PL
RIVERSIDE CA
92504-8724
US

IV. Provider business mailing address

17598 BRETTON WOODS PL
RIVERSIDE CA
92504-8724
US

V. Phone/Fax

Practice location:
  • Phone: 209-420-6720
  • Fax:
Mailing address:
  • Phone: 951-906-3249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: