Provider Demographics
NPI:1205541174
Name:NORCAL MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:NORCAL MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-917-5404
Mailing Address - Street 1:23272 CASITA LN
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96062-9616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23272 CASITA LN
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:CA
Practice Address - Zip Code:96062-9616
Practice Address - Country:US
Practice Address - Phone:530-917-5404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)