Provider Demographics
NPI:1710427364
Name:CORPORATE EXECUTIVE TRANSPORTATION INC.
Entity Type:Organization
Organization Name:CORPORATE EXECUTIVE TRANSPORTATION INC.
Other - Org Name:PERFECT MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-371-1733
Mailing Address - Street 1:1240 E ONTARIO AVE STE 102-324
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-8671
Mailing Address - Country:US
Mailing Address - Phone:951-371-1733
Mailing Address - Fax:
Practice Address - Street 1:19141 BOX CANYON RD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-4239
Practice Address - Country:US
Practice Address - Phone:951-371-1733
Practice Address - Fax:888-912-7645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCP36458343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)