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General NPI Number Information
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NPI Number | 1356693014
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Entity Type | Organization
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Legal Business Name | ADVANCE ACCESS RIDE LLC
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | 2045 COMPTON AVE SUITE NUMBER 203
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City | CORONA
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State | CA
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Zip | 92881-7286
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Country | US
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Telephone | 951-263-2649
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Fax | 951-547-3653
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Provider Business Mailing Address
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Address Line | 2045 COMPTON AVE SUITE NUMBER 203
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City | CORONA
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State | CA
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Zip | 92881-7286
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Country | US
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Telephone | 951-263-2649
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Fax | 951-547-3653
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Authorized Official
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Title or Position | OPERATING MANAGER
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Name | AYMAN BAHTA
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Credential |
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Telephone | 832-781-6159
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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 | TCP0027004 - B
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License Number State | CA
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