Provider Demographics
NPI:1013628650
Name:ELITE MEDTRANS LLC
Entity Type:Organization
Organization Name:ELITE MEDTRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-600-0682
Mailing Address - Street 1:1807 W KATELLA AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-6691
Mailing Address - Country:US
Mailing Address - Phone:714-600-0682
Mailing Address - Fax:714-519-3456
Practice Address - Street 1:1807 W KATELLA AVE STE 212
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-6691
Practice Address - Country:US
Practice Address - Phone:714-600-0682
Practice Address - Fax:714-519-3456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)