MEDICARE: LOS ANGELES MEDICAL TRANSPORTATION LLC

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	:	1487945358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOS ANGELES MEDICAL TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	7305 PACIFIC BLVD
Second Line	:	SECOND FLOOR
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-5736
Country	:	US
Telephone Number	:	323-585-6900
Fax Number	:

Provider Business Practice Location Address
First Line	:	7305 PACIFIC BLVD
Second Line	:	SECOND FLOOR
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-5736
Country	:	US
Telephone Number	:	323-585-6900
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. FELICIANO A. SERRANO II
Credential	:	M.D.
Telephone Number	:	323-585-6900

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	07/08/2011

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