MEDICARE: GMSPARATRANSIT,INC

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)	2762754	CA

General Provider Information

NPI Number	:	1518130913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GMSPARATRANSIT,INC

Provider Business Mailing Address
First Line	:	5733 ARBOR VITAE ST
Second Line	:	SUITE 101
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-4735
Country	:	US
Telephone Number	:	310-645-0480
Fax Number	:	310-645-0683

Provider Business Practice Location Address
First Line	:	5733 ARBOR VITAE ST
Second Line	:	SUITE 101
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-4735
Country	:	US
Telephone Number	:	310-645-0480
Fax Number	:	310-645-0683

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CARLOS A GONZALEZ
Credential	:
Telephone Number	:	310-645-0480

Provider Enumeration Date	:	04/07/2008
Last Update Date	:	04/07/2008

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