Healthcare Provider Details

I. General information

NPI: 1033450408
Provider Name (Legal Business Name): DC LOGISTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2013
Last Update Date: 03/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9971 HIGHCLIFF DR
SANTA ANA CA
92705-1544
US

IV. Provider business mailing address

9971 HIGHCLIFF DR
SANTA ANA CA
92705-1544
US

V. Phone/Fax

Practice location:
  • Phone: 714-515-3669
  • Fax:
Mailing address:
  • Phone: 714-515-3669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DAN DEERING
Title or Position: PRESIDENT
Credential:
Phone: 714-515-3669