Provider Demographics
NPI:1922246669
Name:ALPHATRANS
Entity Type:Organization
Organization Name:ALPHATRANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEGHISHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-552-2002
Mailing Address - Street 1:1815 W KENNETH RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1447
Mailing Address - Country:US
Mailing Address - Phone:818-552-2002
Mailing Address - Fax:
Practice Address - Street 1:1015 N KENILWORTH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2822
Practice Address - Country:US
Practice Address - Phone:818-552-2002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTN00796F343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)