Healthcare Provider Details

I. General information

NPI: 1134887318
Provider Name (Legal Business Name): FRONTLINE MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2021
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8608 UTICA AVE STE 205
RANCHO CUCAMONGA CA
91730-4877
US

IV. Provider business mailing address

6358 ECHO HILLS LN
FONTANA CA
92336-5838
US

V. Phone/Fax

Practice location:
  • Phone: 909-204-5205
  • Fax:
Mailing address:
  • Phone: 909-680-0537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: ALHASAN A SMADI
Title or Position: OWNER
Credential:
Phone: 909-680-0537