MEDICARE: A1 MEDICAL 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	:	1194061945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A1 MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	12534 VALLEY VIEW ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-5540
Country	:	US
Telephone Number	:	562-537-9757
Fax Number	:

Provider Business Practice Location Address
First Line	:	12534 VALLEY VIEW ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-5540
Country	:	US
Telephone Number	:	562-537-9757
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HAMED A ELDAGHASH
Credential	:
Telephone Number	:	562-537-9757

Provider Enumeration Date	:	12/26/2012
Last Update Date	:	02/25/2013

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