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General NPI Number Information
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NPI Number | 1669263406
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Entity Type | Organization
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Legal Business Name | MOBILITYCARE TRANSPORTATION LLC
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 241 N COFFMAN ST
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City | ANAHEIM
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State | CA
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Zip | 92805-7100
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Country | US
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Telephone | 562-419-4711
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Fax | 424-675-4955
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Provider Business Mailing Address
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Address Line | 12816 INGLEWOOD AVE # 620
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City | HAWTHORNE
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State | CA
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Zip | 90250-5118
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Country | US
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Telephone | 562-419-4711
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Fax | 424-675-4955
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Authorized Official
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Title or Position | CEO
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Name | EDISON REBUDAL RAFANAN
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Credential | OWNER
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Telephone | 562-419-4711
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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 |
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License Number State |
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