Provider Demographics
NPI:1437715588
Name:SELF CAL MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:SELF CAL MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEVOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-858-2627
Mailing Address - Street 1:117 S ISABEL ST APT 105
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1170
Mailing Address - Country:US
Mailing Address - Phone:818-858-2627
Mailing Address - Fax:
Practice Address - Street 1:117 S ISABEL ST APT 105
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1170
Practice Address - Country:US
Practice Address - Phone:818-858-2627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SELF CAL MEDICAL TRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)