Provider Demographics
NPI:1912063595
Name:THE TRANSPORT GUY, LLC
Entity Type:Organization
Organization Name:THE TRANSPORT GUY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:MASAMI
Authorized Official - Last Name:TAKAKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:808-778-2169
Mailing Address - Street 1:PO BOX 971082
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1082
Mailing Address - Country:US
Mailing Address - Phone:808-778-2169
Mailing Address - Fax:808-688-0610
Practice Address - Street 1:94-1049 HALEAINA ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-5450
Practice Address - Country:US
Practice Address - Phone:808-778-2169
Practice Address - Fax:808-688-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW19521008-01343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI564684Medicaid