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General NPI Number Information
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NPI Number | 1518346493
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Entity Type | Organization
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Legal Business Name | LIFE CARE MEDICAL TRANSPORT, LLC
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Dates
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Enumeration Date | 05/25/2015
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Last Update Date | 05/25/2015
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Provider Practice Location Address
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Address Line | 727 E SAN YSIDRO BLVD # 148
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City | SAN YSIDRO
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State | CA
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Zip | 92173-3144
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Country | US
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Telephone | 619-277-1535
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Fax |
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Provider Business Mailing Address
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Address Line | 727 E SAN YSIDRO BLVD # 148
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City | SAN YSIDRO
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State | CA
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Zip | 92173-3144
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Country | US
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Telephone | 619-277-1535
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANTHONY SALAZAR
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Credential |
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Telephone | 619-277-1535
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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 | N798
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License Number State | CA
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