Provider Demographics
NPI:1992134951
Name:TITAN MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:TITAN MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMVELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:ST
Authorized Official - Phone:818-731-0043
Mailing Address - Street 1:21201 KITTRIDGE ST APT 1307
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91303-5004
Mailing Address - Country:US
Mailing Address - Phone:818-731-0043
Mailing Address - Fax:
Practice Address - Street 1:21201 KITTRIDGE ST APT 1307
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91303-5004
Practice Address - Country:US
Practice Address - Phone:818-731-0043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-10
Last Update Date:2013-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD1142583343900000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle