Healthcare Provider Details

I. General information

NPI: 1982997680
Provider Name (Legal Business Name): SHUTTLE CALIFORNIA TRANSIT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2011
Last Update Date: 05/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 LEMON ST
VALLEJO CA
94589
US

IV. Provider business mailing address

601 AUBURN DR
VALLEJO CA
94589-1477
US

V. Phone/Fax

Practice location:
  • Phone: 707-645-1000
  • Fax:
Mailing address:
  • Phone: 707-704-8033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number9685
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberTCP 26692-A (CPUC)
License Number StateCA

VIII. Authorized Official

Name: MR. SHAWN PURI
Title or Position: PRESIDENT
Credential:
Phone: 707-704-8033