Provider Demographics
NPI:1750861712
Name:CITYWIDE TRANSPORTATION, INC.
Entity Type:Organization
Organization Name:CITYWIDE TRANSPORTATION, INC.
Other - Org Name:CITIWIDE TRANSPORTATION, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YEFIM
Authorized Official - Middle Name:
Authorized Official - Last Name:GUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-986-1010
Mailing Address - Street 1:14540 VICTORY BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1600
Mailing Address - Country:US
Mailing Address - Phone:818-986-1010
Mailing Address - Fax:818-301-7076
Practice Address - Street 1:14540 VICTORY BLVD STE 210
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1600
Practice Address - Country:US
Practice Address - Phone:818-986-1010
Practice Address - Fax:818-301-7076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)