Healthcare Provider Details

I. General information

NPI: 1962046920
Provider Name (Legal Business Name): TRANQUILITY TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2019
Last Update Date: 06/13/2021
Certification Date: 06/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2667 CAMINO DEL RIO S # 301-12
SAN DIEGO CA
92108-3707
US

IV. Provider business mailing address

2667 CAMINO DEL RIO S # 301-12
SAN DIEGO CA
92108-3707
US

V. Phone/Fax

Practice location:
  • Phone: 619-622-7442
  • Fax:
Mailing address:
  • Phone: 619-622-7442
  • 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 Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: TANIA KHOURI
Title or Position: MANAGER/OWNER
Credential:
Phone: 619-622-7442