=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104788488
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IRC TRANSPORTATION LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/25/2025
-----------------------------------------------------
Last Update Date | 11/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2546 S UNION AVE
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93307-5009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-244-7037
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2546 S UNION AVE
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93307-5009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-244-7037
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | IVAN GABRIEL PEREZAVILA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 619-831-2325
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------