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General NPI Number Information
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NPI Number | 1124734421
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Entity Type | Organization
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Legal Business Name | BICOASTAL MEDICAL TRANSPORTATION, LLC
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 20955 PATHFINDER RD STE 100
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City | DIAMOND BAR
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State | CA
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Zip | 91765-4029
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Country | US
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Telephone | 917-861-6036
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N STATE COLLEGE BLVD STE 1100
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City | ORANGE
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State | CA
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Zip | 92868-1625
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Country | US
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Telephone | 917-861-6036
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHYANNE SANCHEZ
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Credential |
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Telephone | 917-861-6036
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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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