Provider Demographics
NPI:1588043574
Name:CENTRAL VALLEY TRANSPORT
Entity Type:Organization
Organization Name:CENTRAL VALLEY TRANSPORT
Other - Org Name:CENTRAL VALLEY MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGALLANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-385-4702
Mailing Address - Street 1:6083 N. FIGARDEN DR.
Mailing Address - Street 2:#214
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722
Mailing Address - Country:US
Mailing Address - Phone:559-385-4702
Mailing Address - Fax:559-374-6890
Practice Address - Street 1:5670 N SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93723-4002
Practice Address - Country:US
Practice Address - Phone:559-385-4702
Practice Address - Fax:559-374-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201406410169343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)