Provider Demographics
NPI:1982918082
Name:COMFORT MED SHUTTLE
Entity Type:Organization
Organization Name:COMFORT MED SHUTTLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICKLE
Authorized Official - Middle Name:YANGHEE
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-522-1177
Mailing Address - Street 1:11 CHARTHOUSE CV
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1663
Mailing Address - Country:US
Mailing Address - Phone:714-522-1177
Mailing Address - Fax:714-522-1177
Practice Address - Street 1:11 CHARTHOUSE CV
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-1663
Practice Address - Country:US
Practice Address - Phone:714-522-1177
Practice Address - Fax:714-522-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8Y42009343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)