Provider Demographics
NPI:1376826024
Name:A ONE MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:A ONE MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EVERARDO
Authorized Official - Middle Name:JIMENEZ
Authorized Official - Last Name:SORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-464-7173
Mailing Address - Street 1:338 W PALM VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-1454
Mailing Address - Country:US
Mailing Address - Phone:760-464-7173
Mailing Address - Fax:760-770-0216
Practice Address - Street 1:338 W PALM VISTA DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-1454
Practice Address - Country:US
Practice Address - Phone:760-464-7173
Practice Address - Fax:760-770-0216
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A ONE MEDICAL TRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)