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Organization

BROADWAY MEDICAL TRANSPORT

Active
Other names
Jimi O Benson
Organization subpart
No

Provider details

NPI number
Authorized official
IRIS CASTILLO (OFFICE MANAGER)
(619) 651-6393
Entity
Organization

Contact information

Practice address
1351 BROADWAY, EL CAJON, CA 92021-5811
(619) 383-6703
(866) 473-3324
Mailing address
1351 BROADWAY, EL CAJON, CA 92021-5811
(619) 383-6703
(866) 473-3324

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0758740
CA
01
1467276246
NPI
CA
Enumeration date
11/08/2024
Last updated
11/12/2024
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