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General NPI Number Information
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NPI Number | 1578977013
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Entity Type | Organization
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Legal Business Name | CA EXPRESS
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 1523 N MARIPOSA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90027-5101
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Country | US
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Telephone | 213-361-4373
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Fax | 323-644-5404
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Provider Business Mailing Address
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Address Line | 1523 N MARIPOSA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90027-5101
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Country | US
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Telephone | 213-361-4373
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Fax | 323-644-5404
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Authorized Official
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Title or Position | OWNER
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Name | GEVORG DIARYAN
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Credential |
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Telephone | 213-361-4373
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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 | D2281336
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License Number State | CA
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