Provider Demographics
NPI:1437229069
Name:ST PAULS MEDTRANSPORT INC
Entity Type:Organization
Organization Name:ST PAULS MEDTRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-737-7707
Mailing Address - Street 1:1452 ROADRUNNER DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-0711
Mailing Address - Country:US
Mailing Address - Phone:951-737-7707
Mailing Address - Fax:951-737-1734
Practice Address - Street 1:1452 ROADRUNNER DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-0711
Practice Address - Country:US
Practice Address - Phone:951-737-7707
Practice Address - Fax:951-737-1734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTN01153F343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)