Organization
SAN DIEGO MEDICAL TRANSPORT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISAEL LEOBARDO CORONEL (CEO)
(619) 531-8900
Entity
Organization
Contact information
Practice address
864 34TH STREET, SAN DIEGO, CA 92102-3310
(619) 531-8900
(619) 531-8910
Mailing address
864 34TH STREET, SAN DIEGO, CA 92102-3310
(619) 531-8900
(619) 531-8910
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MTN01274F
—
CA
Enumeration date
12/02/2005
Last updated
08/14/2014
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