Provider Demographics
NPI:1053917609
Name:DYNAMIC TRANSPORTATION AND SERVICES
Entity type:Organization
Organization Name:DYNAMIC TRANSPORTATION AND SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:GERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROSAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-681-2219
Mailing Address - Street 1:14825 HAGAR ST
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1712
Mailing Address - Country:US
Mailing Address - Phone:818-681-2219
Mailing Address - Fax:
Practice Address - Street 1:14825 HAGAR ST
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1712
Practice Address - Country:US
Practice Address - Phone:818-681-2219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi