MEDICARE: GT MED TRANS 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	:	1861081119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GT MED TRANS LLC

Provider Business Mailing Address
First Line	:	16241 MARILYN DR
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-3038
Country	:	US
Telephone Number	:	747-744-7529
Fax Number	:

Provider Business Practice Location Address
First Line	:	16241 MARILYN DR
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-3038
Country	:	US
Telephone Number	:	747-744-7529
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TARON TONOYAN
Credential	:
Telephone Number	:	747-744-7529

Provider Enumeration Date	:	01/12/2021
Last Update Date	:	01/12/2021

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