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General NPI Number Information
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NPI Number | 1932665296
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Entity Type | Organization
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Legal Business Name | INFINITI INNOVATIVE HOLDINGS LLC
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 37600 CENTRAL CT STE 218
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City | NEWARK
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State | CA
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Zip | 94560-3456
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Country | US
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Telephone | 510-500-4487
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Fax | 510-868-0257
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Provider Business Mailing Address
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Address Line | PO BOX 211
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City | NEWARK
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State | CA
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Zip | 94560-0211
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Country | US
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Telephone | 510-500-4487
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Fax | 510-868-0257
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Authorized Official
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Title or Position | COO
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Name | EMEM ITE
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Credential | B.SC, MSC (MOT)
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Telephone | 510-500-4487
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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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