Provider Demographics
NPI:1013297639
Name:GENERAL MEDICAL
Entity Type:Organization
Organization Name:GENERAL MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF TRANSPORTATION
Authorized Official - Prefix:
Authorized Official - First Name:GAGIK
Authorized Official - Middle Name:JOEY
Authorized Official - Last Name:MKHITARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-482-9567
Mailing Address - Street 1:1160 N CENTRAL AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-3065
Mailing Address - Country:US
Mailing Address - Phone:818-482-9567
Mailing Address - Fax:
Practice Address - Street 1:1160 N CENTRAL AVE STE 203
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-3065
Practice Address - Country:US
Practice Address - Phone:818-482-9567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)