Provider Demographics
NPI:1831707413
Name:REAL MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:REAL MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAJI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAJIALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-519-9282
Mailing Address - Street 1:9821 APPLE ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-4665
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9821 APPLE ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-4665
Practice Address - Country:US
Practice Address - Phone:619-519-9282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1194375121Medicaid