Provider Demographics
NPI:1497916860
Name:SANTA FE MEDICAL TRANSPORT INC
Entity Type:Organization
Organization Name:SANTA FE MEDICAL TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MENTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-549-1045
Mailing Address - Street 1:9265 DOWDY DR
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6370
Mailing Address - Country:US
Mailing Address - Phone:858-549-1045
Mailing Address - Fax:858-549-1030
Practice Address - Street 1:9265 DOWDY DR
Practice Address - Street 2:SUITE 211
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6370
Practice Address - Country:US
Practice Address - Phone:858-549-1045
Practice Address - Fax:858-549-1030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN01155FMedicaid