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General NPI Number Information
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NPI Number | 1669928230
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Entity Type | Organization
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Legal Business Name | TRAVEL & GROUND NETWORK INC.
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 605 WEST 113 TH. STREET
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City | LOS ANGELES
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State | CA
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Zip | 90044
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Country | US
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Telephone | 855-652-5259
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Fax | 323-242-0487
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Provider Business Mailing Address
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Address Line | 605 W 113TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90044-4213
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Country | US
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Telephone | 855-652-5259
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Fax | 323-242-0487
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THEODORE GLADSTONE NELSON JR.
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Credential |
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Telephone | 855-652-5259
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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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