Provider Demographics
NPI:1972106144
Name:IZRA TRANSPORT INC
Entity Type:Organization
Organization Name:IZRA TRANSPORT INC
Other - Org Name:IZRA TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-626-7383
Mailing Address - Street 1:9747 BUSINESSPARK AVE STE 239
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1661
Mailing Address - Country:US
Mailing Address - Phone:619-626-7383
Mailing Address - Fax:
Practice Address - Street 1:9747 BUSINESSPARK AVE STE 239
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1661
Practice Address - Country:US
Practice Address - Phone:619-626-7383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)