Organization
TELEDELIVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN MICHAEL FRAZIER (CEO/PRESIDENT/OWNER)
(619) 962-9119
Entity
Organization
Contact information
Practice address
430 E 2ND ST, NATIONAL CITY, CA 91950-1309
(619) 962-9119
Mailing address
430 E 2ND ST, NATIONAL CITY, CA 91950-1309
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
D8257243
CA
Other
Enumeration date
12/07/2016
Last updated
12/07/2016
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