Provider Demographics
NPI:1598889610
Name:SILVER MEDICAL TRANSPORTATION, INC
Entity Type:Organization
Organization Name:SILVER MEDICAL TRANSPORTATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DJANGOULIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-461-2525
Mailing Address - Street 1:6051 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-5485
Mailing Address - Country:US
Mailing Address - Phone:323-461-2525
Mailing Address - Fax:323-461-2626
Practice Address - Street 1:6051 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-5485
Practice Address - Country:US
Practice Address - Phone:323-461-2525
Practice Address - Fax:323-461-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN01036FMedicaid