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General NPI Number Information
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NPI Number | 1447569058
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Entity Type | Organization
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Legal Business Name | JBL MED TRANSPORT
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 480 COLLINS AVE STE C
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City | COLMA
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State | CA
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Zip | 94014-3208
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Country | US
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Telephone | 650-296-2685
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Fax | 650-878-5674
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Provider Business Mailing Address
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Address Line | 3625 BETTMAN WAY
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-5203
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Country | US
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Telephone | 650-296-2685
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Fax | 650-878-5674
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAY ANTHONY GARCIA RICAFORT
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Credential |
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Telephone | 650-296-2685
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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 | A2145112
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License Number State | CA
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