Healthcare Provider Details

I. General information

NPI: 1699141309
Provider Name (Legal Business Name): MEDICAL TRANSPORTATION OF CALIF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2015
Last Update Date: 08/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 NOSTALGIA AVE
PATTERSON CA
95363-8348
US

IV. Provider business mailing address

45 NOSTALGIA AVE
PATTERSON CA
95363-8348
US

V. Phone/Fax

Practice location:
  • Phone: 209-894-8919
  • Fax: 209-894-8919
Mailing address:
  • Phone: 209-894-8919
  • Fax: 209-894-8919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MOHAMMED M EWAIS
Title or Position: OWNER
Credential:
Phone: 209-894-8919