Provider Demographics
NPI:1306038765
Name:MED EXPRESS TRANSPORTION
Entity Type:Organization
Organization Name:MED EXPRESS TRANSPORTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RABAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-828-0869
Mailing Address - Street 1:7056 CROW CANYON RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-9685
Mailing Address - Country:US
Mailing Address - Phone:510-828-0869
Mailing Address - Fax:
Practice Address - Street 1:7056 CROW CANYON RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-9685
Practice Address - Country:US
Practice Address - Phone:510-828-0869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2015-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
CA121103343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)