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General NPI Number Information
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NPI Number | 1295246767
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Entity Type | Organization
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Legal Business Name | MAAGBOY ENTERPRISE LLC
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 7181 MAGNOLIA PL
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City | FONTANA
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State | CA
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Zip | 92336-5715
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Country | US
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Telephone | 626-488-7129
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Fax |
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Provider Business Mailing Address
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Address Line | 7181 MAGNOLIA PL
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City | FONTANA
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State | CA
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Zip | 92336-5715
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MARVIN ANTONIO ARANA GARCIA
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Credential |
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Telephone | 626-488-7129
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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 | 51860F2
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License Number State | CA
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