Ellen Medical Transport
Non-emergency Medical Transport (VAN) in San Diego, CA. Organization (NPI-2).
NPI number1982125605
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1982125605
- Entity type
- Organization (NPI-2)
- Legal business name
- Ellen Medical Transport
- Organization subpart
- No
- Enumeration date
- Jul 3, 2017
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 343900000X | Non-emergency Medical Transport (VAN) | 2017007484 | CA | Yes |
Other names
- Northside Medical Transport (Doing Business As)
Practice location
4587 Winona Ave #5San Diego, CA 92115
Phone 619-315-1062
Mailing address
4587 Winona Ave Apt 5San Diego, CA 92115-3339
Phone 619-315-1062
Authorized official
Dawit Fesshaye
C.E.O
6193151062
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