Provider Demographics
NPI:1619342896
Name:AMERICAN CAB LLC
Entity Type:Organization
Organization Name:AMERICAN CAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLIBANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-486-8000
Mailing Address - Street 1:72048 WOBURN CT
Mailing Address - Street 2:
Mailing Address - City:THOUSAND PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92276-2319
Mailing Address - Country:US
Mailing Address - Phone:760-329-3002
Mailing Address - Fax:
Practice Address - Street 1:72048 WOBURN CT
Practice Address - Street 2:
Practice Address - City:THOUSAND PALMS
Practice Address - State:CA
Practice Address - Zip Code:92276-2319
Practice Address - Country:US
Practice Address - Phone:760-329-3002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi