Healthcare Provider Details

I. General information

NPI: 1619384203
Provider Name (Legal Business Name): CITY LINK FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8721 TROY STREET
SPRING VALLEY CA
91977-2537
US

IV. Provider business mailing address

8721 TROY STREET
SPRING VALLEY CA
91977-2537
US

V. Phone/Fax

Practice location:
  • Phone: 619-287-0628
  • Fax: 619-469-1983
Mailing address:
  • Phone: 619-287-0628
  • Fax: 619-469-1983

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: MRS. CYNTHIA YVONNE SANDERS
Title or Position: CEO
Credential:
Phone: 619-287-0628