Healthcare Provider Details

I. General information

NPI: 1508682303
Provider Name (Legal Business Name): MST TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 11/26/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7508 LETTY AVE
LAMONT CA
93241-2363
US

IV. Provider business mailing address

7508 LETTY AVE
LAMONT CA
93241-2363
US

V. Phone/Fax

Practice location:
  • Phone: 661-573-9225
  • Fax:
Mailing address:
  • Phone: 661-573-9225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARCOS PRADO
Title or Position: OWNER
Credential:
Phone: 661-573-9225