Provider Demographics
NPI:1215231105
Name:MILBRAD MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:MILBRAD MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EFE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGHORIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-504-2576
Mailing Address - Street 1:4220 ABERFOIL AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-5402
Mailing Address - Country:US
Mailing Address - Phone:510-504-2576
Mailing Address - Fax:510-562-0535
Practice Address - Street 1:4220 ABERFOIL AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-5402
Practice Address - Country:US
Practice Address - Phone:510-504-2576
Practice Address - Fax:510-562-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC2561410343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)