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NPI Code Detail

MEDICARE: SONOMA COUNTY TRANSPORTATION LLC

MEDICARE: SONOMA COUNTY TRANSPORTATION LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1344600000XTaxi

General Provider Information

NPI Number : 1184405573
Entity Type Code : Organization
Provider Name (Legal Business Name) : SONOMA COUNTY TRANSPORTATION LLC
Provider Business Mailing Address
First Line : 2925 CLEVELAND AVE # G
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-2715
Country : US
Telephone Number : 602-500-3641
Fax Number :
Provider Business Practice Location Address
First Line : 2925 CLEVELAND AVE # G
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-2715
Country : US
Telephone Number : 602-500-3641
Fax Number :
Authorized Official
Title or Position : OWNER
Name : BRADLEY J RISNER
Credential :
Telephone Number : 602-500-3641
Provider Enumeration Date : 10/11/2023
Last Update Date : 10/11/2023

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Directions to “SONOMA COUNTY TRANSPORTATION LLC ” Practice Location

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