1548318751 NPI number — ST. ANTHONY MEDICAL TRANSPORTATION, INC.

Table of content: (NPI 1548318751)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548318751 NPI number — ST. ANTHONY MEDICAL TRANSPORTATION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. ANTHONY MEDICAL TRANSPORTATION, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548318751
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15120 ATKINSON AVE
Provider Second Line Business Mailing Address:
SUITE #8
Provider Business Mailing Address City Name:
GARDENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90249-4037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-952-1280
Provider Business Mailing Address Fax Number:
818-364-8824

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15120 ATKINSON AVE
Provider Second Line Business Practice Location Address:
SUITE # 8
Provider Business Practice Location Address City Name:
GARDENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90249-3637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-952-1280
Provider Business Practice Location Address Fax Number:
818-364-8824
Provider Enumeration Date:
01/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RAMOS
Authorized Official First Name:
CESAR
Authorized Official Middle Name:
BALUYOT
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
310-952-1280

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , with the licence number:  MTN01006F , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com