Organization
SHAW PEARSON TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI SHAW (PRESIDENT)
(760) 530-7590
Entity
Organization
Contact information
Practice address
11150 ADDISON ST, ADELANTO, CA 92301-4616
(760) 530-7590
(760) 530-7591
Mailing address
P.O BOX 1238, ADELANTO, CA 92301
(760) 530-7590
(760) 530-7591
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
00405356
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00405356
CA LICENSE #
—
Enumeration date
08/22/2016
Last updated
08/27/2016
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