Provider Demographics
NPI:1881812089
Name:VALLEY MEDICAL TRANSPORT, LLC.
Entity type:Organization
Organization Name:VALLEY MEDICAL TRANSPORT, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-423-3298
Mailing Address - Street 1:2471 MAIN ST STE 16
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-4657
Mailing Address - Country:US
Mailing Address - Phone:619-423-3298
Mailing Address - Fax:619-426-4790
Practice Address - Street 1:2471 MAIN ST STE 16
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-4657
Practice Address - Country:US
Practice Address - Phone:619-423-3298
Practice Address - Fax:619-426-4790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)