Organization
CJ WELLNET INC
Active
Other names
Wellnet Medi-Van Transportation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW F. SPROWLS (VICE PRESIDENT)
(714) 337-1671
Entity
Organization
Contact information
Practice address
2021 E 4TH ST., 209, SANTA ANA, CA 92705-3913
(714) 665-6591
(714) 632-8409
Mailing address
2021 E 4TH ST., 209, SANTA ANA, CA 92705-3913
(714) 665-6591
(714) 632-8409
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
MTN01188F
CA
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MTN01188F
—
CA
05
—
MTNX10007
—
CA
Enumeration date
11/01/2006
Last updated
12/17/2019
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