Healthcare Provider Details

I. General information

NPI: 1326562653
Provider Name (Legal Business Name): DELTA MEDICAL TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6470 FOOTHILL BLVD # D
TUJUNGA CA
91042
US

IV. Provider business mailing address

6470 FOOTHILL BLVD # D
TUJUNGA CA
91042-2729
US

V. Phone/Fax

Practice location:
  • Phone: 818-642-4464
  • Fax:
Mailing address:
  • Phone: 818-642-4464
  • Fax: 818-688-0680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: DAVIT MKHITARYAN
Title or Position: CEO
Credential:
Phone: 818-642-4464