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General NPI Number Information
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NPI Number | 1538236765
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Entity Type | Organization
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Legal Business Name | VANTAGE TRANSPORTS, INC.
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 460 W LARCH RD STE 12
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City | TRACY
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State | CA
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Zip | 95304-1652
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Country | US
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Telephone | 209-475-0708
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Fax | 209-475-0709
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Provider Business Mailing Address
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Address Line | 460 W LARCH RD STE 12
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City | TRACY
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State | CA
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Zip | 95304-1652
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Country | US
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Telephone | 209-475-0708
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Fax | 209-475-0709
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAIME A GOCHOCO
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Credential |
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Telephone | 209-475-0708
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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 | C-2460479
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License Number State | CA
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