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General NPI Number Information
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NPI Number | 1649674557
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Entity Type | Organization
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Legal Business Name | SECURE RADIO & TRANSPORTATION LLC
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 10/21/2014
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Provider Practice Location Address
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Address Line | 4226 UNIVERSITY AVE
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City | SAN DIEGO
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State | CA
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Zip | 92105-1503
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Country | US
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Telephone | 619-550-1555
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Fax | 619-550-1888
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Provider Business Mailing Address
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Address Line | 4226 UNIVERSITY AVE
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City | SAN DIEGO
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State | CA
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Zip | 92105-1503
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Country | US
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Telephone | 619-550-1555
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Fax | 619-550-1888
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. ABRAHAM TESSEMA
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Credential | BS, MBA
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Telephone | 619-550-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | 18279K1
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 63669G1
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License Number State | CA
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