Organization
SSJ MEDICAL TRANSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AIDA MARIA HIPOLITO RETIRED RN (OWNER)
(714) 749-7961
Entity
Organization
Contact information
Practice address
8262 SOUTHPORT DR, HUNTINGTON BEACH, CA 92646-4441
(714) 749-7961
(714) 969-5630
Mailing address
8262 SOUTHPORT DR, HUNTINGTON BEACH, CA 92646-4441
(714) 749-7961
(714) 969-5630
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
MTN01007F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MTN01007F
—
CA
Enumeration date
12/22/2006
Last updated
08/22/2020
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