Healthcare Provider Details

I. General information

NPI: 1932029774
Provider Name (Legal Business Name): BAY AREA MOBILITY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4742 CAMPBELL AVE APT 28
SAN JOSE CA
95130-1772
US

IV. Provider business mailing address

4742 CAMPBELL AVE APT 28
SAN JOSE CA
95130-1772
US

V. Phone/Fax

Practice location:
  • Phone: 408-658-7534
  • Fax:
Mailing address:
  • Phone: 408-658-7534
  • 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: ALEX G WOLDEMARIAM
Title or Position: OWNER
Credential:
Phone: 408-658-7534