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General NPI Number Information
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NPI Number | 1003523275
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Entity Type | Organization
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Legal Business Name | ST. MARK MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 02/23/2025
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Provider Practice Location Address
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Address Line | 207 S MAPLE AVE
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-6305
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Country | US
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Telephone | 650-880-2588
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Fax |
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Provider Business Mailing Address
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Address Line | 455 HICKEY BLVD STE 521
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City | DALY CITY
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State | CA
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Zip | 94015-2631
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Country | US
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Telephone | 650-483-2169
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MARK VICTOR IGNACIO
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Credential |
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Telephone | 650-483-2169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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