Provider Demographics
NPI:1871029835
Name:STAR PATIENT TRANSPORT
Entity Type:Organization
Organization Name:STAR PATIENT TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-530-6077
Mailing Address - Street 1:23813 CUSHENBURY DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-3231
Mailing Address - Country:US
Mailing Address - Phone:951-530-6077
Mailing Address - Fax:
Practice Address - Street 1:23813 CUSHENBURY DR
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-3231
Practice Address - Country:US
Practice Address - Phone:951-530-6077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30464343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)