Provider Demographics
NPI:1265536312
Name:MEDLINK MEDICAL TRANSPORT,INC.
Entity type:Organization
Organization Name:MEDLINK MEDICAL TRANSPORT,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:D
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-630-0850
Mailing Address - Street 1:14716 S MARIPOSA AVE
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-2908
Mailing Address - Country:US
Mailing Address - Phone:310-630-0850
Mailing Address - Fax:310-769-1402
Practice Address - Street 1:1919 W REDONDO BEACH BLVD STE 102
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3655
Practice Address - Country:US
Practice Address - Phone:310-630-0850
Practice Address - Fax:310-769-1402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN01056GMedicaid