Provider Demographics
NPI:1467081976
Name:JKJP LLC
Entity Type:Organization
Organization Name:JKJP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:T
Authorized Official - Last Name:PUNZALAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-698-8888
Mailing Address - Street 1:10537 SLATER AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4841
Mailing Address - Country:US
Mailing Address - Phone:714-698-8888
Mailing Address - Fax:
Practice Address - Street 1:10537 SLATER AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4841
Practice Address - Country:US
Practice Address - Phone:714-698-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)