Healthcare Provider Details

I. General information

NPI: 1669387387
Provider Name (Legal Business Name): ELITE PATIENT TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7036 ELCAJON BLVD
SAN DIEGO CA
92115
US

IV. Provider business mailing address

7036 ELCAJON BLVD, SUITE D 7036 ELCAJON BLVD, SUITE D
SAN DIEGO CA
92115
US

V. Phone/Fax

Practice location:
  • Phone: 619-788-1962
  • Fax:
Mailing address:
  • Phone: 619-788-1962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ABUUKAR AHMED MOHAMED
Title or Position: CEO
Credential:
Phone: 619-788-1962