Organization
PACIFIC COAST MEDICAL TRANSPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY WILLARD PEDERSON (MANAGING MEMBER)
(805) 591-0000
Entity
Organization
Contact information
Practice address
160 RIVERVIEW DR, AVILA BEACH, CA 93424-3535
(805) 591-0000
Mailing address
PO BOX 2623, AVILA BEACH, CA 93424-2623
(805) 591-0000
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
07/24/2022
Last updated
07/24/2022
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