Provider Demographics
NPI:1073792370
Name:RADIANT MEDTRANS INC.
Entity Type:Organization
Organization Name:RADIANT MEDTRANS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DIXON
Authorized Official - Middle Name:BUMATAY
Authorized Official - Last Name:CRISTOBAL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:951-318-9970
Mailing Address - Street 1:3564 CENTRAL AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2727
Mailing Address - Country:US
Mailing Address - Phone:951-781-8701
Mailing Address - Fax:951-781-8704
Practice Address - Street 1:3564 CENTRAL AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2727
Practice Address - Country:US
Practice Address - Phone:951-781-8701
Practice Address - Fax:951-781-8704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3047203343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)