Organization
EXTRA CARE MEDICAL TRANSPORT
Active
Organization
EXTRA CARE MEDICAL TRANSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SENECA MONET WALKER (OWNER)
(323) 422-2512
Entity
Organization
Contact information
Practice address
5150 CANDLEWOOD ST, SUITE 17 F, LAKEWOOD, CA 90712-1925
(323) 422-2512
Mailing address
5150 CANDLEWOOD STREET, SUITE 17 F, LAKEWOOD, CA 90217-1927
(323) 422-2512
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
20080705
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201613010103
—
CA
Enumeration date
04/27/2017
Last updated
04/27/2017
Update your record
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