MEDICARE: J&A 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	:	1598495954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J&A MEDICAL TRANSPORT

Provider Business Mailing Address
First Line	:	1402 W PICO AVE STE 23
Second Line	:
City	:	EL CENTRO
State	:	CA
Zip	:	92243-1377
Country	:	US
Telephone Number	:	442-297-7996
Fax Number	:

Provider Business Practice Location Address
First Line	:	1402 W PICO AVE STE 23
Second Line	:
City	:	EL CENTRO
State	:	CA
Zip	:	92243-1377
Country	:	US
Telephone Number	:	442-297-7996
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	ALBERTO VASQUEZ
Credential	:
Telephone Number	:	442-297-7996

Provider Enumeration Date	:	06/16/2022
Last Update Date	:	06/20/2022

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