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General NPI Number Information
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NPI Number | 1063386035
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Entity Type | Organization
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Legal Business Name | BLUE CHAIR OF CALIFORNIA
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 5665 MAIN ST SPC 7
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City | KELSEYVILLE
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State | CA
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Zip | 95451-9495
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Country | US
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Telephone | 925-812-4646
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Fax |
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Provider Business Mailing Address
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Address Line | 1905 CONCORD BLVD UNIT 242
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City | CONCORD
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State | CA
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Zip | 94520-2811
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Country | US
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Telephone | 925-812-4646
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Fax |
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Authorized Official
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Title or Position | PART OWNER
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Name | JOHN HENRY JONES
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Credential | CEO
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Telephone | 510-672-3545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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