MEDICARE: OC CARE 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
1	343900000X	Non-emergency Medical Transport (VAN)		CA

General Provider Information

NPI Number	:	1386122307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OC CARE TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	23101 MOULTON PKWY STE 206B
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1235
Country	:	US
Telephone Number	:	833-200-1221
Fax Number	:

Provider Business Practice Location Address
First Line	:	23101 MOULTON PKWY STE 206B
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1235
Country	:	US
Telephone Number	:	833-200-1221
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS OWNER
Name	:	PEZHMAN RAJABI
Credential	:
Telephone Number	:	833-200-1221

Provider Enumeration Date	:	08/01/2018
Last Update Date	:	08/01/2018

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