=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265900096
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RIGHT RIDE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2018
-----------------------------------------------------
Last Update Date | 11/09/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1023 WEST ARROW HWY APT A
-----------------------------------------------------
City | UPLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91786
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-489-7293
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1023 WEST ARROW HWY APT A
-----------------------------------------------------
City | UPLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91786
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-489-7293
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MIKE SEDAT SAFI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 951-489-7293
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 172A00000X
-----------------------------------------------------
Taxonomy Name | Driver
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------