Healthcare Provider Details

I. General information

NPI: 1265186266
Provider Name (Legal Business Name): CITY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2022
Last Update Date: 09/18/2022
Certification Date: 09/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6470 EL CAJON BLVD APT 231
SAN DIEGO CA
92115-2665
US

IV. Provider business mailing address

6470 EL CAJON BLVD APT 231
SAN DIEGO CA
92115-2665
US

V. Phone/Fax

Practice location:
  • Phone: 619-791-4642
  • Fax:
Mailing address:
  • Phone:
  • 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: FEYSAL AWEYS
Title or Position: ECO
Credential:
Phone: 619-791-4642