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General NPI Number Information
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NPI Number | 1609312941
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Entity Type | Organization
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Legal Business Name | ABW EXPRESS LLC
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 13528 LEMOLI AVE APT 16
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City | HAWTHORNE
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State | CA
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Zip | 90250-8724
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Country | US
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Telephone | 323-532-1157
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Fax |
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Provider Business Mailing Address
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Address Line | 13528 LEMOLI AVE APT 16
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City | HAWTHORNE
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State | CA
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Zip | 90250-8724
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Country | US
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Telephone | 323-532-1157
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAEMIAN TRESANDO SOUTH
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Credential | PROVIDER
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Telephone | 323-532-1157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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