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General NPI Number Information
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NPI Number | 1306222583
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Entity Type | Organization
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Legal Business Name | STAT MEDICAL TRANSPORT, LLC
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 11/02/2018
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Provider Practice Location Address
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Address Line | 497 S 4TH ST
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City | EL CENTRO
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State | CA
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Zip | 92243-3003
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Country | US
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Telephone | 760-592-4181
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 59116
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City | NORWALK
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State | CA
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Zip | 90652-0116
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Country | US
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Telephone | 760-592-4181
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | ABRAHAM MALDONADO
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Credential |
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Telephone | 760-909-7244
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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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