Organization
VIP NEMT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR PORTILLO (CEO)
(202) 096-3184
Entity
Organization
Contact information
Practice address
21724 ROAD 30, MADERA, CA 93638-8005
(209) 631-8435
Mailing address
PO BOX 181, ATWATER, CA 95301-0181
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
09/30/2022
Last updated
09/30/2022
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