Provider Demographics
NPI:1558779165
Name:SYNERGY TRANSIT
Entity Type:Organization
Organization Name:SYNERGY TRANSIT
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSELITO
Authorized Official - Middle Name:SEGISMUNDO
Authorized Official - Last Name:MANTILLA
Authorized Official - Suffix:
Authorized Official - Credentials:NON EMERGENCY
Authorized Official - Phone:562-569-6117
Mailing Address - Street 1:9080 BLOOMFIELD AVE
Mailing Address - Street 2:SPACE 163
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2445
Mailing Address - Country:US
Mailing Address - Phone:562-569-6117
Mailing Address - Fax:714-723-6587
Practice Address - Street 1:2528 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-6432
Practice Address - Country:US
Practice Address - Phone:714-699-1288
Practice Address - Fax:714-723-6587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABUS2013-01530343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)