Healthcare Provider Details

I. General information

NPI: 1215560933
Provider Name (Legal Business Name): PACIFIC CAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 ELIAS DR
UNION CITY CA
94587-5480
US

IV. Provider business mailing address

224 ELIAS DR
UNION CITY CA
94587-5480
US

V. Phone/Fax

Practice location:
  • Phone: 510-258-5611
  • Fax:
Mailing address:
  • Phone: 510-258-5611
  • 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: GUL RAHIMI
Title or Position: OWNER
Credential:
Phone: 510-258-5611