Organization
TELLY JAYA TRANSPORTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAYA SATRIYA UTAMA (MANAGER)
(661) 886-0287
Entity
Organization
Contact information
Practice address
190 SIERRA CT., UNIT B # A-115, PALMDALE, CA 93550-7607
(661) 886-0285
(661) 213-9733
Mailing address
190 SIERRA CT., UNIT B # A-115, PALMDALE, CA 93550-7607
(661) 886-0287
(661) 213-9733
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
10/30/2018
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