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General NPI Number Information
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NPI Number | 1982963088
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Entity Type | Organization
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Legal Business Name | A & G ACTIVITY SERVICES
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 1314 W 12TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90015-2009
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Country | US
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Telephone | 213-763-0500
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Fax | 213-763-0587
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Provider Business Mailing Address
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Address Line | 1314 W 12TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90015-2009
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Country | US
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Telephone | 213-763-0500
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Fax | 213-763-0587
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MS. RENE LEE
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Credential |
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Telephone | 213-763-0500
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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 | 039266
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License Number State | CA
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