MEDICARE: MEDICAL TRANSPORTATION SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	2343395	CA

General Provider Information

NPI Number	:	1649428251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL TRANSPORTATION SERVICES

Provider Business Mailing Address
First Line	:	6650 KENTLAND AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-3735
Country	:	US
Telephone Number	:	818-451-6951
Fax Number	:	818-888-3808

Provider Business Practice Location Address
First Line	:	6650 KENTLAND AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-3735
Country	:	US
Telephone Number	:	818-451-6951
Fax Number	:	818-888-3808

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BABAK GHORBANIAN
Credential	:
Telephone Number	:	818-451-6951

Provider Enumeration Date	:	09/08/2008
Last Update Date	:	09/08/2008

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Directions to “MEDICAL TRANSPORTATION SERVICES ” Practice Location

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