Provider Demographics
NPI:1124462551
Name:NORTHRIDGE MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:NORTHRIDGE MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:R
Authorized Official - Last Name:LUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-892-9170
Mailing Address - Street 1:8611 COLLETT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-5743
Mailing Address - Country:US
Mailing Address - Phone:818-892-9170
Mailing Address - Fax:
Practice Address - Street 1:21000 DEVONSHIRE ST
Practice Address - Street 2:#203
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2360
Practice Address - Country:US
Practice Address - Phone:818-389-8540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)