Provider Demographics
NPI:1972143295
Name:DAVE, DARWIN RACAR
Entity Type:Individual
Prefix:MR
First Name:DARWIN
Middle Name:RACAR
Last Name:DAVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E KIMBERLY CT
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-4187
Mailing Address - Country:US
Mailing Address - Phone:909-556-1698
Mailing Address - Fax:909-363-8568
Practice Address - Street 1:205 E KIMBERLY CT
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-4187
Practice Address - Country:US
Practice Address - Phone:909-556-1698
Practice Address - Fax:909-363-8568
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)