Provider Demographics
NPI:1992227607
Name:OCLA TRANSPORTATION
Entity type:Organization
Organization Name:OCLA TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARIDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-333-5020
Mailing Address - Street 1:1221 N STATE COLLEGE BLVD APT 37
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-1526
Mailing Address - Country:US
Mailing Address - Phone:1714-333-5020
Mailing Address - Fax:714-982-7560
Practice Address - Street 1:1221 N STATE COLLEGE BLVD APT 37
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-1526
Practice Address - Country:US
Practice Address - Phone:714-333-5020
Practice Address - Fax:714-982-7560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201710910421343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)