Provider Demographics
NPI:1801661954
Name:DA NOBREGA NETO, ADIR AMARAL
Entity type:Individual
Prefix:MR
First Name:ADIR
Middle Name:AMARAL
Last Name:DA NOBREGA NETO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 HICKORY AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6072
Mailing Address - Country:US
Mailing Address - Phone:424-222-1975
Mailing Address - Fax:
Practice Address - Street 1:1500 HICKORY AVE APT 102
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6072
Practice Address - Country:US
Practice Address - Phone:424-222-1975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB9915978343800000X, 347C00000X, 347E00000X, 342000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker