Provider Demographics
NPI:1497529689
Name:ACT MEDICAL TRANSPORTATION INC.
Entity Type:Organization
Organization Name:ACT MEDICAL TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FATTAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-635-4775
Mailing Address - Street 1:12191 CUYAMACA COLLEGE DR E UNIT 807
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-4351
Mailing Address - Country:US
Mailing Address - Phone:619-636-6784
Mailing Address - Fax:
Practice Address - Street 1:12191 CUYAMACA COLLEGE DR E UNIT 807
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-4351
Practice Address - Country:US
Practice Address - Phone:619-635-4775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)