Healthcare Provider Details

I. General information

NPI: 1407683592
Provider Name (Legal Business Name): ALPHA 3 TRANSPORTATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10465 MIRACLE WATERS CT
SPRING VALLEY CA
91977-3452
US

IV. Provider business mailing address

10465 MIRACLE WATERS CT
SPRING VALLEY CA
91977-3452
US

V. Phone/Fax

Practice location:
  • Phone: 619-830-7122
  • Fax:
Mailing address:
  • Phone: 619-830-7122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. STEVE JIRJEES
Title or Position: PRESIDENT
Credential:
Phone: 619-830-7122