=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902025398
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PREMIER MEDICAL TRANSPORT, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2007
-----------------------------------------------------
Last Update Date | 07/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 260 N PALM ST # 200
-----------------------------------------------------
City | BREA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92821-2870
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-256-2141
-----------------------------------------------------
Fax | 888-353-3175
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 260 N PALM ST # 200
-----------------------------------------------------
City | BREA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92821-2870
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-256-2141
-----------------------------------------------------
Fax | 888-353-3175
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ADRIAN DEHGHANMANESH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-256-2141
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------