Provider Demographics
NPI:1265692040
Name:GUARDIAN ANGEL TRANSPORTATION
Entity type:Organization
Organization Name:GUARDIAN ANGEL TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NA
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:DENELL
Authorized Official - Last Name:PAREDES
Authorized Official - Suffix:I
Authorized Official - Credentials:NA
Authorized Official - Phone:530-632-3900
Mailing Address - Street 1:3014 FORSTNER CT
Mailing Address - Street 2:3014 FORSTNER COURT
Mailing Address - City:LIVE OAK
Mailing Address - State:CA
Mailing Address - Zip Code:95953-2046
Mailing Address - Country:US
Mailing Address - Phone:530-632-3900
Mailing Address - Fax:
Practice Address - Street 1:3014 FORSTNER CT
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:CA
Practice Address - Zip Code:95953-2046
Practice Address - Country:US
Practice Address - Phone:530-632-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-14
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)