Provider Demographics
NPI:1912220104
Name:JAZSTROM, INC
Entity Type:Organization
Organization Name:JAZSTROM, INC
Other - Org Name:AID TO RIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASPER
Authorized Official - Middle Name:P
Authorized Official - Last Name:SOLIVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-992-2388
Mailing Address - Street 1:713 W COMMONWEALTH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1662
Mailing Address - Country:US
Mailing Address - Phone:714-992-2388
Mailing Address - Fax:714-992-2322
Practice Address - Street 1:713 W COMMONWEALTH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1662
Practice Address - Country:US
Practice Address - Phone:714-992-2388
Practice Address - Fax:714-992-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)