Provider Demographics
NPI:1669263406
Name:MOBILITYCARE TRANSPORTATION LLC
Entity type:Organization
Organization Name:MOBILITYCARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDISON
Authorized Official - Middle Name:REBUDAL
Authorized Official - Last Name:RAFANAN
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:562-419-4711
Mailing Address - Street 1:12816 INGLEWOOD AVE # 620
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5118
Mailing Address - Country:US
Mailing Address - Phone:562-419-4711
Mailing Address - Fax:424-675-4955
Practice Address - Street 1:241 N COFFMAN ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-7100
Practice Address - Country:US
Practice Address - Phone:562-419-4711
Practice Address - Fax:424-675-4955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)