Provider Demographics
NPI:1659890622
Name:ONE ACCESS MEDICAL TRANSPORTATION SOUTH BAY
Entity Type:Organization
Organization Name:ONE ACCESS MEDICAL TRANSPORTATION SOUTH BAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-650-8958
Mailing Address - Street 1:7921 ENTERPRISE DR STE C
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-3460
Mailing Address - Country:US
Mailing Address - Phone:408-650-8958
Mailing Address - Fax:
Practice Address - Street 1:7921 ENTERPRISE DR STE C
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-3460
Practice Address - Country:US
Practice Address - Phone:408-650-8958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)