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General NPI Number Information
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NPI Number | 1821556093
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Entity Type | Organization
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Legal Business Name | PRIORITY EXPRESS TRANSPORT
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Dates
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Enumeration Date | 03/06/2019
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Last Update Date | 03/06/2019
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Provider Practice Location Address
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Address Line | 25062 SOUTHPORT ST
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-4921
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Country | US
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Telephone | 949-680-8704
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Fax |
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Provider Business Mailing Address
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Address Line | 23615 EL TORO RD STE X186
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City | LAKE FOREST
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State | CA
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Zip | 92630-4707
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Country | US
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Telephone | 949-680-8704
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUAN CARLOS CONTRERAS
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Credential |
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Telephone | 949-680-8704
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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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