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General NPI Number Information
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NPI Number | 1174982516
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Entity Type | Organization
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Legal Business Name | FUN N GO NON MEDICAL TRANSPORT
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Dates
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Enumeration Date | 02/13/2016
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 1900 CAMDEN AVE SUITE 201
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City | SAN JOSE
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State | CA
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Zip | 95124-2942
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Country | US
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Telephone | 844-238-6646
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 CAMDEN AVE SUITE 201
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City | SAN JOSE
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State | CA
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Zip | 95124-2942
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Country | US
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Telephone | 844-238-6646
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | MS. MARIA CURA DIMBLA
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Credential |
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Telephone | 408-656-8988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | C3829627
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License Number State | CA
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