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General NPI Number Information
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NPI Number | 1285484345
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Entity Type | Organization
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Legal Business Name | EAST BAY MEDICAL TRANSPORTATION
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 301 GEORGIA ST STE 340A
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City | VALLEJO
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State | CA
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Zip | 94590-5997
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Country | US
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Telephone | 800-481-5540
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1253
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City | SUISUN CITY
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State | CA
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Zip | 94585-1253
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Country | US
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Telephone | 800-481-5540
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Fax | 800-481-5540
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Authorized Official
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Title or Position | OWNER
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Name | DENISHA WAGNER-PERRY
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Credential |
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Telephone | 800-481-5540
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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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