Organization
NON EMERGENCY TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD GAGNON (VICE PRESIDENT PARTNER)
(949) 412-0792
Entity
Organization
Contact information
Practice address
17151 NEWHOPE ST, SUITE #212, FOUNTAIN VALLEY, CA 92708-4226
(672) 210-4426
Mailing address
PO BOX 7673, HUNTINGTON BEACH, CA 92615-7673
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APPLYING FOR
MEDI-CAL
CA
Enumeration date
03/26/2013
Last updated
03/26/2013
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