MEDICARE: G & H 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	:	1245382621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	G & H MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	3306 GLENDALE BLVD STE 7
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90039-1838
Country	:	US
Telephone Number	:	323-913-2828
Fax Number	:	323-913-0880

Provider Business Practice Location Address
First Line	:	3306 GLENDALE BLVD STE 7
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90039-1838
Country	:	US
Telephone Number	:	323-913-2828
Fax Number	:	323-913-0880

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ANITA DERMENDJIAN
Credential	:
Telephone Number	:	323-913-2828

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	08/22/2020

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