Provider Demographics
NPI:1699559328
Name:LA MED TRANS CORPORATION
Entity type:Organization
Organization Name:LA MED TRANS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DRIVER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHOT
Authorized Official - Middle Name:
Authorized Official - Last Name:GAFAFYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-578-5059
Mailing Address - Street 1:28408 HIDDEN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91390-4292
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10545 BURBANK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2246
Practice Address - Country:US
Practice Address - Phone:323-578-5059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty