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General NPI Number Information
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NPI Number | 1871823120
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Entity Type | Organization
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Legal Business Name | CALIFORNIA MEDICAL CONVEYANCE
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Dates
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Enumeration Date | 01/09/2010
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 30111 TECHNOLOGY DR SUITE 110
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City | MURRIETA
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State | CA
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Zip | 92563-2655
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Country | US
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Telephone | 818-296-7532
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Fax | 678-904-3449
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Provider Business Mailing Address
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Address Line | 30111 TECHNOLOGY DR SUITE 110
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City | MURRIETA
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State | CA
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Zip | 92563-2655
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Country | US
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Telephone | 818-296-7532
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Fax | 678-904-3449
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEREENYAGA BAMIDELE YAZID
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Credential | CNA
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Telephone | 818-296-7532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State | CA
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