MEDICARE: ASSURED MEDICAL TRANSPORT

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	:	1407118870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURED MEDICAL TRANSPORT

Provider Business Mailing Address
First Line	:	421 S ROCK RIVER RD
Second Line	:
City	:	DIAMOND BAR
State	:	CA
Zip	:	91765-1562
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1342 PASEO ENCINAS
Second Line	:
City	:	SAN DIMAS
State	:	CA
Zip	:	91773-4217
Country	:	US
Telephone Number	:	818-481-7818
Fax Number	:	714-459-7189

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN CHOU
Credential	:
Telephone Number	:	818-481-7818

Provider Enumeration Date	:	06/12/2012
Last Update Date	:	06/12/2012

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Directions to “ASSURED MEDICAL TRANSPORT ” Practice Location

Language	Start Address	Practice Location

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