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General NPI Number Information
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NPI Number | 1124897657
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Entity Type | Organization
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Legal Business Name | MJ-TRANSPORT LLC
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Dates
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Enumeration Date | 12/26/2023
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 20 TORREGATA LOOP # 288
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City | SAN JOSE
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State | CA
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Zip | 95134-1533
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Country | US
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Telephone | 682-307-3257
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Fax |
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Provider Business Mailing Address
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Address Line | 20 TORREGATA LOOP
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City | SAN JOSE
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State | CA
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Zip | 95134-1533
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MOJTABA MRGANI
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Credential |
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Telephone | 682-307-3257
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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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