1699827857 NPI number — UNITED MED TRANSPORT, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699827857 NPI number — UNITED MED TRANSPORT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED MED TRANSPORT, 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:
1699827857
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10311 SPRUCE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLFLOWER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90706-7211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-867-9810
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19112 GRIDLEY RD
Provider Second Line Business Practice Location Address:
SUITE 238
Provider Business Practice Location Address City Name:
CERRITOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90703-6630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-867-9810
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WONG
Authorized Official First Name:
ZENAIDA
Authorized Official Middle Name:
ESPIRITU
Authorized Official Title or Position:
CHAIRMAN OF THE BOARD
Authorized Official Telephone Number:
562-867-9810

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , 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)

  • Identifier: MTN00813F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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