Provider Demographics
NPI:1861713653
Name:AMERICAN MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:AMERICAN MEDICAL TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEVAK
Authorized Official - Middle Name:
Authorized Official - Last Name:VARTANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-634-5876
Mailing Address - Street 1:859 E ROUTE 66 STE G
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-3609
Mailing Address - Country:US
Mailing Address - Phone:626-335-5828
Mailing Address - Fax:
Practice Address - Street 1:859 E ROUTE 66 STE G
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-3609
Practice Address - Country:US
Practice Address - Phone:626-335-5828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-16
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD4006340343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)