Provider Demographics
NPI:1235437997
Name:GOLDEN STATE MEDICAL TRANSPORT, LLC
Entity Type:Organization
Organization Name:GOLDEN STATE MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:THRUSH
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:619-888-4900
Mailing Address - Street 1:2177 SPLENDORWOOD PL
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-1421
Mailing Address - Country:US
Mailing Address - Phone:619-888-4900
Mailing Address - Fax:
Practice Address - Street 1:2177 SPLENDORWOOD PL
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-1421
Practice Address - Country:US
Practice Address - Phone:619-888-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport