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General NPI Number Information
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NPI Number | 1972383529
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Entity Type | Organization
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Legal Business Name | VIVO TRANSPORTATION
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 22436 BERDON ST
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-4406
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Country | US
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Telephone | 818-263-0860
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Fax |
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Provider Business Mailing Address
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Address Line | 22436 BERDON ST
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-4406
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Country | US
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Telephone | 818-263-0860
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. SHAHRYAR MOALLEM
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Credential |
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Telephone | 818-475-0750
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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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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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