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General NPI Number Information
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NPI Number | 1639013998
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Entity Type | Organization
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Legal Business Name | 1800MEDIVAN OR, INC.
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 15159 PALMDALE RD
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City | VICTORVILLE
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State | CA
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Zip | 92392-2547
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Country | US
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Telephone | 800-633-4826
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Fax | 760-951-1922
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Provider Business Mailing Address
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Address Line | 581 LANCASTER DR SE STE 382
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City | SALEM
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State | OR
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Zip | 97317-5642
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Country | US
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Telephone | 800-633-4826
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Fax | 760-951-1922
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Authorized Official
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Title or Position | PRESIDENT
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Name | YURI HAMBARDZUMYAN
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Credential |
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Telephone | 800-633-4826
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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 |
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License Number State |
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