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General NPI Number Information
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NPI Number | 1255410346
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Entity Type | Organization
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Legal Business Name | MEDSAM TRANSPORTATION
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 674 42ND AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-2533
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Country | US
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Telephone | 415-561-0628
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Fax | 415-561-0621
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Provider Business Mailing Address
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Address Line | 674 42ND AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-2533
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Country | US
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Telephone | 415-561-0628
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Fax | 415-561-0621
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SEMYON PORTNOY
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Credential |
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Telephone | 415-561-0628
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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 | MTN01016F
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License Number State | CA
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