Healthcare Provider Details

I. General information

NPI: 1811384910
Provider Name (Legal Business Name): UNICORN MEDICAL TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 04/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14617 VICTORY BLVD STE 2
VAN NUYS CA
91411-1675
US

IV. Provider business mailing address

14617 VICTORY BLVD STE 2
VAN NUYS CA
91411-1675
US

V. Phone/Fax

Practice location:
  • Phone: 747-777-6208
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: HARUTYUN KAMIKYAN
Title or Position: CEO
Credential:
Phone: 818-912-9070