Healthcare Provider Details

I. General information

NPI: 1750366068
Provider Name (Legal Business Name): PROTRANSPORT 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 COMMERCE BLVD STE 111
ROHNERT PARK CA
94928-2181
US

IV. Provider business mailing address

PO BOX 31001-2208
PASADENA CA
91110-2208
US

V. Phone/Fax

Practice location:
  • Phone: 707-665-4289
  • Fax: 707-703-4619
Mailing address:
  • Phone: 707-665-4295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1830
License Number StateCA

VIII. Authorized Official

Name: JUSTIN MEISER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 330-217-2652