Provider Demographics
NPI:1083717136
Name:ROGELIO MALANA
Entity Type:Organization
Organization Name:ROGELIO MALANA
Other - Org Name:RAINBOW MEDICAL TRANSPORT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MALANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-427-5610
Mailing Address - Street 1:1611 LOMA LANE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911
Mailing Address - Country:US
Mailing Address - Phone:619-427-5610
Mailing Address - Fax:619-425-7777
Practice Address - Street 1:1611 LOMA LANE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911
Practice Address - Country:US
Practice Address - Phone:619-427-5610
Practice Address - Fax:619-425-7777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN000935FOtherCALIFORNIA DEPT OF HEALTH