Provider Demographics
NPI:1770832362
Name:ACCURATE CARE TRANSPORTATION
Entity Type:Organization
Organization Name:ACCURATE CARE TRANSPORTATION
Other - Org Name:PROVIDENCE MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOON JA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-522-3842
Mailing Address - Street 1:601 N. VERMONT AVE.
Mailing Address - Street 2:#105
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004
Mailing Address - Country:US
Mailing Address - Phone:323-522-3842
Mailing Address - Fax:323-522-3844
Practice Address - Street 1:601 N. VERMONT AVE.
Practice Address - Street 2:105
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004
Practice Address - Country:US
Practice Address - Phone:323-522-3842
Practice Address - Fax:323-522-3844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3496370343900000X
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)