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General NPI Number Information
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NPI Number | 1184091811
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Entity Type | Organization
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Legal Business Name | J. V. MEDI-TRANSP, LLC
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 1400 EASTON DR STE 147E
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City | BAKERSFIELD
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State | CA
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Zip | 93309-9406
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Country | US
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Telephone | 661-839-8224
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Fax |
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Provider Business Mailing Address
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Address Line | 709 DESERT CALICO DR
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City | LANCASTER
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State | CA
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Zip | 93534-1563
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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 | MR. JESUS ANTONIO VALENCIA JR.
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Credential |
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Telephone | 661-839-8224
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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 | CA
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