Provider Demographics
NPI:1609585314
Name:UNITED TAXI WORKERS OF SAN DIEGO
Entity Type:Organization
Organization Name:UNITED TAXI WORKERS OF SAN DIEGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIKAIIL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-721-4565
Mailing Address - Street 1:4265 FAIRMOUNT AVE STE 180
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-6404
Mailing Address - Country:US
Mailing Address - Phone:619-255-7355
Mailing Address - Fax:619-255-7375
Practice Address - Street 1:4265 FAIRMOUNT AVE STE 180
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-6404
Practice Address - Country:US
Practice Address - Phone:619-255-7355
Practice Address - Fax:619-255-7375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANONEMedicaid