Provider Demographics
NPI:1265080493
Name:NAMBU TRANSPORT LLC
Entity type:Organization
Organization Name:NAMBU TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:RAFANAN
Authorized Official - Last Name:RABENA
Authorized Official - Suffix:VII
Authorized Official - Credentials:
Authorized Official - Phone:951-809-1156
Mailing Address - Street 1:654 BONNIE CLAIRE DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4184
Mailing Address - Country:US
Mailing Address - Phone:951-809-1156
Mailing Address - Fax:626-581-3902
Practice Address - Street 1:654 BONNIE CLAIRE DR
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-4184
Practice Address - Country:US
Practice Address - Phone:951-809-1156
Practice Address - Fax:626-581-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)