Provider Demographics
NPI:1114157096
Name:STAR MEDICAL TRANSPORTATION INC.
Entity Type:Organization
Organization Name:STAR MEDICAL TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:NISHIMURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-532-3200
Mailing Address - Street 1:350 CRENSHAW BLVD
Mailing Address - Street 2:SUITE A 202
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1724
Mailing Address - Country:US
Mailing Address - Phone:310-532-3200
Mailing Address - Fax:310-787-8805
Practice Address - Street 1:350 CRENSHAW BLVD
Practice Address - Street 2:SUITE A 202
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1724
Practice Address - Country:US
Practice Address - Phone:310-532-3200
Practice Address - Fax:310-787-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-25
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19683416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport