Healthcare Provider Details

I. General information

NPI: 1730343989
Provider Name (Legal Business Name): DAVID MEDICAL TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 PARK CITY CT APT 8206
SACRAMENTO CA
95831-6106
US

IV. Provider business mailing address

40 PARK CITY CT APT 8206
SACRAMENTO CA
95831-6106
US

V. Phone/Fax

Practice location:
  • Phone: 916-400-4817
  • Fax: 916-400-4911
Mailing address:
  • Phone: 916-400-4817
  • Fax: 916-400-4911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GREGORY WAYNE WHATLEY
Title or Position: OWNER
Credential:
Phone: 916-400-4817