Provider Demographics
NPI:1710067632
Name:PROFESSIONAL ACTION MEDICAL TRANSPORT, INC
Entity Type:Organization
Organization Name:PROFESSIONAL ACTION MEDICAL TRANSPORT, INC
Other - Org Name:ACTION MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:DE GUZMAN
Authorized Official - Last Name:PAPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-467-2088
Mailing Address - Street 1:4749 ELMWOOD AVE
Mailing Address - Street 2:PO BOX 743159
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-3110
Mailing Address - Country:US
Mailing Address - Phone:323-467-2088
Mailing Address - Fax:323-666-2878
Practice Address - Street 1:4749 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3110
Practice Address - Country:US
Practice Address - Phone:323-467-2088
Practice Address - Fax:323-666-2878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTN01054G343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)