Provider Demographics
NPI:1467752113
Name:SOCAL MEDTRANS
Entity Type:Organization
Organization Name:SOCAL MEDTRANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-982-5222
Mailing Address - Street 1:13659 VICTORY BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1735
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12501 CHANDLER BLVD
Practice Address - Street 2:STE 103
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-1941
Practice Address - Country:US
Practice Address - Phone:818-982-5222
Practice Address - Fax:818-982-9674
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOCAL MED SERVICES. INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-28
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)