Provider Demographics
NPI:1679685655
Name:DOLTOM TRANSPORTATION
Entity type:Organization
Organization Name:DOLTOM TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOYIN
Authorized Official - Middle Name:OLADAPO
Authorized Official - Last Name:OLOGUNDUDU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-957-2855
Mailing Address - Street 1:4910 VIOLET CT
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-3008
Mailing Address - Country:US
Mailing Address - Phone:209-957-2855
Mailing Address - Fax:209-957-7993
Practice Address - Street 1:4910 VIOLET CT
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-3008
Practice Address - Country:US
Practice Address - Phone:209-957-2855
Practice Address - Fax:209-957-7993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA06-00066602343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)