MEDICARE: ALPHATRANS

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)	MTN00796F	CA

General Provider Information

NPI Number	:	1922246669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHATRANS

Provider Business Mailing Address
First Line	:	1815 W KENNETH RD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-1447
Country	:	US
Telephone Number	:	818-552-2002
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 N KENILWORTH AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2822
Country	:	US
Telephone Number	:	818-552-2002
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	SUSAN YEGHISHIAN
Credential	:
Telephone Number	:	818-552-2002

Provider Enumeration Date	:	02/03/2009
Last Update Date	:	02/03/2009

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Directions to “ALPHATRANS ” Practice Location

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