Provider Demographics
NPI:1255100525
Name:OGL TRANSPORTATION LLC
Entity type:Organization
Organization Name:OGL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:OBNER
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:GUERRA SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-798-6016
Mailing Address - Street 1:5922 SMOKE TREE RD
Mailing Address - Street 2:
Mailing Address - City:PHELAN
Mailing Address - State:CA
Mailing Address - Zip Code:92371-7420
Mailing Address - Country:US
Mailing Address - Phone:323-798-6016
Mailing Address - Fax:
Practice Address - Street 1:5922 SMOKE TREE RD
Practice Address - Street 2:
Practice Address - City:PHELAN
Practice Address - State:CA
Practice Address - Zip Code:92371-7420
Practice Address - Country:US
Practice Address - Phone:323-798-6016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriver