Individual provider Active NPI

Afshin Mirbolooki

  • Non-emergency Medical Transport (VAN)
  • Riverside, CA
National Provider Identifier
1104532308
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
3610 Central Ave Ste 400
Riverside, CA 92506-5907
Phone
(951) 899-0048
Fax
(951) 900-1614
NPI assigned
Jan 31, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

3610 Central Ave Ste 400
Riverside, CA 92506-5907

Mailing address

3610 Central Ave Ste 400
Riverside, CA 92506-5907
Phone (951) 899-0048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobility Moto, LLC Non-Emergency Medical Transport (Van) PastSince Feb 1, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677888000000",
    "number": "1104532308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 CENTRAL AVE STE 400",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925065907",
            "telephone_number": "951-899-0048",
            "fax_number": "951-900-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 CENTRAL AVE STE 400",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925065907",
            "telephone_number": "951-899-0048",
            "fax_number": "951-900-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRBOLOOKI",
        "first_name": "AFSHIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.