Organization
ELLEN MEDICAL TRANSPORT
Active
Organization
ELLEN MEDICAL TRANSPORT
Active
Other names
Northside Medical Transport
Organization subpart
No
Provider details
NPI number
Authorized official
DAWIT FESSHAYE (C.E.O)
(619) 315-1062
Entity
Organization
Contact information
Practice address
4587 WINONA AVE #5, SAN DIEGO, CA 92115
(619) 315-1062
Mailing address
4587 WINONA AVE APT 5, SAN DIEGO, CA 92115-3339
(619) 315-1062
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
2017007484
CA
Other
Enumeration date
07/03/2017
Last updated
07/21/2022
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