Healthcare Provider Details

I. General information

NPI: 1245158864
Provider Name (Legal Business Name): FOOTHILLS MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3495 LAKEVIEW DR
IONE CA
95640-9613
US

IV. Provider business mailing address

3495 LAKEVIEW DR
IONE CA
95640-9613
US

V. Phone/Fax

Practice location:
  • Phone: 209-790-9265
  • Fax: 800-217-0876
Mailing address:
  • Phone: 209-790-9265
  • Fax: 800-217-0876

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: HECTOR DURAN FLORES
Title or Position: MEMBER
Credential:
Phone: 209-790-9265