Provider Demographics
NPI:1831254754
Name:LYNSTEB INC
Entity type:Organization
Organization Name:LYNSTEB INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-776-0815
Mailing Address - Street 1:19528 VENTURA BLVD # 198
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2917
Mailing Address - Country:US
Mailing Address - Phone:818-776-0815
Mailing Address - Fax:818-776-9365
Practice Address - Street 1:18422 GAULT ST
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4315
Practice Address - Country:US
Practice Address - Phone:818-776-0815
Practice Address - Fax:818-776-9365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000017011500013343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN00790FMedicaid