Captain Med Go LLC

Primary specialty

Transportation Network CompanyTaxonomy code 342000000X

Legal business name

CAPTAIN MED GO LLC

Practice address

4116 New York Ave
La Crescenta, CA 91214-3353

Phone

(818) 423-6404

NPI assigned

May 29, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel Khachatourian

Title

Ceo

Phone

(818) 423-6404

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1013757871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4116 NEW YORK AVE",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143353",
            "telephone_number": "818-423-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4116 NEW YORK AVE",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143353",
            "telephone_number": "818-423-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPTAIN MED GO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "KHACHATOURIAN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-423-6404"
    },
    "taxonomies": [
        {
            "code": "342000000X",
            "taxonomy_group": "",
            "desc": "Transportation Network Company",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Transportation Network Company in La Crescenta, CA
• Providers in La Crescenta, CA by specialty
• Transportation Network Company in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.