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General NPI Number Information
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NPI Number | 1740338045
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Entity Type | Organization
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Legal Business Name | MEDCARE MEDICAL TRANSPORTATION, INC
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 03/29/2011
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Provider Practice Location Address
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Address Line | 8531 LANKERSHIM BLVD STE B
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City | SUN VALLEY
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State | CA
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Zip | 91352-3127
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Country | US
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Telephone | 818-786-4572
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Fax |
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Provider Business Mailing Address
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Address Line | 8531 LANKERSHIM BLVD STE B
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City | SUN VALLEY
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State | CA
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Zip | 91352-3127
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Country | US
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Telephone | 818-786-4572
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PAVEL RASKIN
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Credential |
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Telephone | 818-505-0846
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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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Legacy Identifiers
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Identifier #1
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Identifier Code | MTN01053G
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Identifier Type | MEDICAID
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Identifier State | CA
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | MTN01053G
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Identifier Type | MEDICAID
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Identifier State | CA
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Identifier Issuer |
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