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General NPI Number Information
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NPI Number | 1912272329
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Entity Type | Organization
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Legal Business Name | BLUE ZONE TRANSPORTATION CO
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Dates
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Enumeration Date | 03/19/2012
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | 3553 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90018-3825
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Country | US
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Telephone | 310-807-1614
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 452121
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City | LOS ANGELES
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State | CA
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Zip | 90045-8527
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Country | US
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Telephone | 310-807-1614
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHERY LILY DE LA CRUZ HAASLER
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Credential |
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Telephone | 310-807-1614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State | CA
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