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General NPI Number Information
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NPI Number | 1720582042
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Entity Type | Organization
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Legal Business Name | VIDA NON-EMERGENCY TRANSPORTATION SERVICES INC.
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 528 E BELLEVUE RD STE B
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City | ATWATER
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State | CA
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Zip | 95301-2339
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Country | US
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Telephone | 209-769-2982
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Fax |
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Provider Business Mailing Address
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Address Line | 1472 CLOVERFIELD CT
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City | ATWATER
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State | CA
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Zip | 95301-4069
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Country | US
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Telephone | 209-769-2982
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Fax |
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Authorized Official
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Title or Position | CEO (OWNER)
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Name | ELISEO PRADO-LUPIAN
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Credential |
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Telephone | 209-769-6546
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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 | CA
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