| NPI | 1770832362 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL TRANSPORTATION |
| Entity Type | Organization |
| Authorized Contact | SOON JA KIM CEO 323-522-3842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: CA 3496370) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2016-01-13 |