Provider Demographics
NPI:1326365180
Name:BAYSIDE MEDICAL TRANSPORATION LLC
Entity Type:Organization
Organization Name:BAYSIDE MEDICAL TRANSPORATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALOHI
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-270-0020
Mailing Address - Street 1:4901 MORENA BLVD STE 208B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3569
Mailing Address - Country:US
Mailing Address - Phone:858-270-0020
Mailing Address - Fax:868-270-0160
Practice Address - Street 1:4901 MORENA BLVD STE 208B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3569
Practice Address - Country:US
Practice Address - Phone:858-270-0020
Practice Address - Fax:868-270-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)