=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487930657
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOORTODOOR LL INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2011
-----------------------------------------------------
Last Update Date | 11/01/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2405 W FLORENCE AVE
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90043-5104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-751-5100
-----------------------------------------------------
Fax | 323-751-5112
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 43369
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90043-0369
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-751-5100
-----------------------------------------------------
Fax | 323-751-5112
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TRANSPORTATION CORD.
-----------------------------------------------------
Name | RAY W TAYLOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 323-751-5100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------