MEDICARE: 3PAUL'S TRANSPORTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1043965478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	3PAUL'S TRANSPORTATION

Provider Business Mailing Address
First Line	:	940 S BUCKNELL CIR
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-5002
Country	:	US
Telephone Number	:	714-624-0757
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 S BUCKNELL CIR
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-5002
Country	:	US
Telephone Number	:	714-624-0757
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	EDJOZON PAUL N MACANDILI
Credential	:
Telephone Number	:	714-624-0757

Provider Enumeration Date	:	02/14/2022
Last Update Date	:	02/14/2022

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