Provider Demographics
NPI:1871823120
Name:CALIFORNIA MEDICAL CONVEYANCE
Entity type:Organization
Organization Name:CALIFORNIA MEDICAL CONVEYANCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEREENYAGA
Authorized Official - Middle Name:BAMIDELE
Authorized Official - Last Name:YAZID
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:818-296-7532
Mailing Address - Street 1:30111 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2655
Mailing Address - Country:US
Mailing Address - Phone:818-296-7532
Mailing Address - Fax:678-904-3449
Practice Address - Street 1:30111 TECHNOLOGY DR
Practice Address - Street 2:SUITE 110
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2655
Practice Address - Country:US
Practice Address - Phone:818-296-7532
Practice Address - Fax:678-904-3449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-09
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition