Provider Demographics
NPI:1215604814
Name:OMEGA TRANSPORTATION SERVICES L L C
Entity Type:Organization
Organization Name:OMEGA TRANSPORTATION SERVICES L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C E O
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAUTISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-398-3400
Mailing Address - Street 1:3063 W CHAPMAN AVE
Mailing Address - Street 2:#2128
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-1741
Mailing Address - Country:US
Mailing Address - Phone:657-282-8307
Mailing Address - Fax:
Practice Address - Street 1:3063 W CHAPMAN AVE
Practice Address - Street 2:#2128
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1741
Practice Address - Country:US
Practice Address - Phone:657-282-8307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date: