Provider Demographics
NPI:1538846282
Name:AWNI, KAID
Entity type:Individual
Prefix:MR
First Name:KAID
Middle Name:
Last Name:AWNI
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 1:11201 5TH ST APT H303
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0902
Mailing Address - Country:US
Mailing Address - Phone:909-289-2260
Mailing Address - Fax:
Practice Address - Street 1:11201 5TH ST APT H303
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0902
Practice Address - Country:US
Practice Address - Phone:909-289-2260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAY3605438343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)