Provider Demographics
NPI:1689471484
Name:CRESCENT MED TRANS
Entity type:Organization
Organization Name:CRESCENT MED TRANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:ISMAIL
Authorized Official - Last Name:HEIBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:840-444-0747
Mailing Address - Street 1:16675 SLATE DR UNIT 236
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-7406
Mailing Address - Country:US
Mailing Address - Phone:840-444-0747
Mailing Address - Fax:
Practice Address - Street 1:1345 S DIAMOND BAR BLVD STE U
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4151
Practice Address - Country:US
Practice Address - Phone:840-444-0747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No344600000XTransportation ServicesTaxi