Provider Demographics
NPI:1376969238
Name:WEST COAST ENTERPRISES, LLC
Entity Type:Organization
Organization Name:WEST COAST ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:626-394-5219
Mailing Address - Street 1:1443 E WASHINGTON BLVD
Mailing Address - Street 2:STE 235
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2650
Mailing Address - Country:US
Mailing Address - Phone:626-394-5219
Mailing Address - Fax:
Practice Address - Street 1:1443 E WASHINGTON BLVD
Practice Address - Street 2:STE 235
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-2650
Practice Address - Country:US
Practice Address - Phone:626-394-5219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA343900000XMedicaid