Provider Demographics
NPI:1366959215
Name:GENTLE CARE MEDICAL TRANSPORTATION, LLC
Entity type:Organization
Organization Name:GENTLE CARE MEDICAL TRANSPORTATION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHHADULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-576-7090
Mailing Address - Street 1:13115 ACACIA AVE
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-6908
Mailing Address - Country:US
Mailing Address - Phone:909-576-7090
Mailing Address - Fax:
Practice Address - Street 1:13115 ACACIA AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-6908
Practice Address - Country:US
Practice Address - Phone:909-576-7090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2278P4000X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No2278P4000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPatient TransportGroup - Single Specialty