Provider Demographics
NPI:1245946409
Name:INLAND EMPIRE MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:INLAND EMPIRE MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDLYN
Authorized Official - Middle Name:ANDREINA
Authorized Official - Last Name:ESCANDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:442-342-5497
Mailing Address - Street 1:1173 D ST
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-2110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1173 D ST
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-2110
Practice Address - Country:US
Practice Address - Phone:951-383-1140
Practice Address - Fax:951-364-1844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9331947-2023OtherSTATE FUND WORKERS COMP