Provider Demographics
NPI:1235841669
Name:CHERI'S CAFE
Entity Type:Organization
Organization Name:CHERI'S CAFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:DE JESUS
Authorized Official - Last Name:CRUZ LANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-909-5581
Mailing Address - Street 1:2014 MABURY ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-7149
Mailing Address - Country:US
Mailing Address - Phone:714-909-5581
Mailing Address - Fax:
Practice Address - Street 1:13876 HARBOR BLVD STE 3B
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4029
Practice Address - Country:US
Practice Address - Phone:714-909-5581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)