Provider Demographics
NPI:1326562653
Name:DELTA MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:DELTA MEDICAL TRANSPORTATION
Other - Org Name:DELTA MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVIT
Authorized Official - Middle Name:
Authorized Official - Last Name:MKHITARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-642-4464
Mailing Address - Street 1:6470 FOOTHILL BLVD # D
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2729
Mailing Address - Country:US
Mailing Address - Phone:818-642-4464
Mailing Address - Fax:818-688-0680
Practice Address - Street 1:6470 FOOTHILL BLVD # D
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042
Practice Address - Country:US
Practice Address - Phone:818-642-4464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker