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General NPI Number Information
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NPI Number | 1649755240
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Entity Type | Organization
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Legal Business Name | DIVERSIFIED TRANSPORTATION ACCESS, LLC
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Dates
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Enumeration Date | 09/28/2018
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Last Update Date | 09/28/2018
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Provider Practice Location Address
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Address Line | 5777 W CENTURY BLVD STE 1601
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City | LOS ANGELES
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State | CA
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Zip | 90045-5696
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Country | US
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Telephone | 310-925-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 241803
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City | LOS ANGELES
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State | CA
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Zip | 90024-9603
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Country | US
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Telephone | 310-925-2000
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Fax |
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | BINYAMIN BAREL
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Credential |
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Telephone | 310-435-0710
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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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