Healthcare Provider Details

I. General information

NPI: 1528502382
Provider Name (Legal Business Name): ZOOM MEDICAL TRANSPORTATION 001 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2016
Last Update Date: 12/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12915 ROSELLE AVE #2
HAWTHORNE CA
90250-5366
US

IV. Provider business mailing address

12915 ROSELLE AVE #2
HAWTHORNE CA
90250-5366
US

V. Phone/Fax

Practice location:
  • Phone: 310-617-1525
  • Fax:
Mailing address:
  • Phone: 310-617-1525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateCA

VIII. Authorized Official

Name: ANDREA HURNS
Title or Position: CEO
Credential:
Phone: 310-617-1525