Provider Demographics
NPI:1023409893
Name:MEDNET INC.
Entity type:Organization
Organization Name:MEDNET INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-718-6080
Mailing Address - Street 1:PO BOX 371694
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91337-1694
Mailing Address - Country:US
Mailing Address - Phone:818-718-6080
Mailing Address - Fax:718-625-1559
Practice Address - Street 1:8300 TAMPA AVE
Practice Address - Street 2:SUITE J
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4267
Practice Address - Country:US
Practice Address - Phone:818-718-6080
Practice Address - Fax:718-625-1559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5544343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)