Provider Demographics
NPI:1871523068
Name:SILVER AGE NONE-EMERGENCY MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:SILVER AGE NONE-EMERGENCY MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MILANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-285-0585
Mailing Address - Street 1:14540 HAMLIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1626
Mailing Address - Country:US
Mailing Address - Phone:818-285-0585
Mailing Address - Fax:818-285-0585
Practice Address - Street 1:14540 HAMLIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1626
Practice Address - Country:US
Practice Address - Phone:818-285-0585
Practice Address - Fax:818-285-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285911-02343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN01149FOtherMEDI-CAL