Provider Demographics
NPI:1467694026
Name:MMB TRANSPORTATION SERVICES, LLC
Entity Type:Organization
Organization Name:MMB TRANSPORTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:LARA
Authorized Official - Last Name:DEL ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-757-1085
Mailing Address - Street 1:239 BELHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4208
Mailing Address - Country:US
Mailing Address - Phone:650-757-1085
Mailing Address - Fax:650-757-1085
Practice Address - Street 1:239 BELHAVEN AVE
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4208
Practice Address - Country:US
Practice Address - Phone:650-757-1085
Practice Address - Fax:650-757-1085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-29
Last Update Date:2009-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200829510116343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)