=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417758012
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAB NON EMERGENCY MEDICAL TRANSPORT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2025
-----------------------------------------------------
Last Update Date | 03/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3011 RED GRANITE DR
-----------------------------------------------------
City | EL DORADO HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95762-4631
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-889-9430
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3011 RED GRANITE DR
-----------------------------------------------------
City | EL DORADO HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95762-4631
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-889-9430
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | FARAH ABADI
-----------------------------------------------------
Credential | FARAH ABADI
-----------------------------------------------------
Telephone | 408-889-9430
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------