Provider Demographics
NPI:1265982797
Name:ADAM CAB
Entity type:Organization
Organization Name:ADAM CAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIKADIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDISALAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-358-5230
Mailing Address - Street 1:5451 MANDARIN CV
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-6052
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5451 MANDARIN CV
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-6052
Practice Address - Country:US
Practice Address - Phone:619-358-5230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD349448344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi