Provider Demographics
NPI:1669401931
Name:GMD TRANSPORTATION, INC.
Entity type:Organization
Organization Name:GMD TRANSPORTATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-872-0963
Mailing Address - Street 1:660 MONTEREY PASS RD STE 138A
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-2440
Mailing Address - Country:US
Mailing Address - Phone:626-872-0963
Mailing Address - Fax:626-872-0965
Practice Address - Street 1:660 MONTEREY PASS RD STE 138A
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-2440
Practice Address - Country:US
Practice Address - Phone:626-872-0963
Practice Address - Fax:626-872-0965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN00729FMedicaid