Provider Demographics
NPI:1831643931
Name:GOLDEN STATE MEDICAL TRANSPORTATION, INC
Entity Type:Organization
Organization Name:GOLDEN STATE MEDICAL TRANSPORTATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTAK
Authorized Official - Middle Name:
Authorized Official - Last Name:HARUTYUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-899-8585
Mailing Address - Street 1:6366 N FIGARDEN DR STE 107
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-7946
Mailing Address - Country:US
Mailing Address - Phone:559-899-8585
Mailing Address - Fax:559-277-3898
Practice Address - Street 1:6366 N FIGARDEN DR STE 107
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-7946
Practice Address - Country:US
Practice Address - Phone:559-899-8585
Practice Address - Fax:559-277-3898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)