Healthcare Provider Details

I. General information

NPI: 1316436686
Provider Name (Legal Business Name): SAN DIEGO METROPOLITAN TRANSIT SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 IMPERIAL AVE STE 1000
SAN DIEGO CA
92101-7490
US

IV. Provider business mailing address

1255 IMPERIAL AVE STE 1000
SAN DIEGO CA
92101-7490
US

V. Phone/Fax

Practice location:
  • Phone: 619-231-1465
  • Fax:
Mailing address:
  • Phone: 619-231-1465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: PAUL JABLONSKI
Title or Position: CEO
Credential:
Phone: 619-231-1465