Healthcare Provider Details

I. General information

NPI: 1144528100
Provider Name (Legal Business Name): AMG MEDICAL TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2011
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 S REAL RD
BAKERSFIELD CA
93309-2135
US

IV. Provider business mailing address

PO BOX 42198
BAKERSFIELD CA
93384-2198
US

V. Phone/Fax

Practice location:
  • Phone: 562-964-5024
  • Fax:
Mailing address:
  • Phone: 562-964-5024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: ABRAHAM MALDONADO
Title or Position: OWNER/OPERATOR
Credential:
Phone: 562-964-5024