Provider Demographics
NPI:1528569175
Name:ETS EXPRESS TRANS SYS
Entity Type:Organization
Organization Name:ETS EXPRESS TRANS SYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MESFIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAWEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-893-3235
Mailing Address - Street 1:14032 ENDERLE CENTER DR STE 204
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2040
Mailing Address - Country:US
Mailing Address - Phone:866-200-0900
Mailing Address - Fax:
Practice Address - Street 1:14032 ENDERLE CENTER DR STE 204
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2040
Practice Address - Country:US
Practice Address - Phone:866-200-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)