Provider Demographics
NPI:1750366068
Name:PROTRANSPORT 1
Entity type:Organization
Organization Name:PROTRANSPORT 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-217-2652
Mailing Address - Street 1:PO BOX 31001-2208
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91110-2208
Mailing Address - Country:US
Mailing Address - Phone:707-665-4295
Mailing Address - Fax:
Practice Address - Street 1:6040 COMMERCE BLVD STE 111
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2181
Practice Address - Country:US
Practice Address - Phone:707-665-4289
Practice Address - Fax:707-703-4619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-08
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1830341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA292158OtherMANAGED HEALTH NETWORK
CAZZZ05021ZOtherBLUE SHIELD
CAZZZ22445ZOtherMEDICARE PTN
CA352176400OtherACS US DEPT. OF LABOR
CAMTN01132FMedicaid