Healthcare Provider Details

I. General information

NPI: 1932024742
Provider Name (Legal Business Name): EXPRESS MEDICAL RIDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16839 ODELL AVE
VICTORVILLE CA
92394-1093
US

IV. Provider business mailing address

16839 ODELL AVE
VICTORVILLE CA
92394-1093
US

V. Phone/Fax

Practice location:
  • Phone: 714-676-6092
  • Fax:
Mailing address:
  • Phone: 714-676-6092
  • 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: LEONEL GALVAN
Title or Position: CEO
Credential:
Phone: 714-676-6092