Pacific Coast Medical Transport, LLC

Primary specialty

Private VehicleTaxonomy code 347C00000X

Legal business name

PACIFIC COAST MEDICAL TRANSPORT, LLC

Practice address

160 Riverview Dr
Avila Beach, CA 93424-3535

Phone

(805) 591-0000

NPI assigned

Jul 24, 2022

Organization subpart

No

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

Authorized official

Name

Gary Willard Pederson

Title

Managing Member

Phone

(805) 591-0000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1658620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658620800000",
    "number": "1144955048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2623",
            "city": "AVILA BEACH",
            "state": "CA",
            "postal_code": "934242623",
            "telephone_number": "805-591-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 RIVERVIEW DR",
            "city": "AVILA BEACH",
            "state": "CA",
            "postal_code": "934243535",
            "telephone_number": "805-591-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST MEDICAL TRANSPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-24",
        "last_updated": "2022-07-24",
        "certification_date": "2022-07-24",
        "status": "A",
        "authorized_official_last_name": "PEDERSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "WILLARD",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "805-591-0000"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yelena S Lapidus, MD
• Jessica Jo Lieland, P.A.
• Mary Jane Mees, L.AC. DAOM
• Michael Harris LMFT
• Christel Leona O'Rourke, CMT
• Erich Rueschenberg, PH.D.
• Nancy G. Rueschenberg, PH.D.
• Sedghi Momentum Health Chiropractic
• Shirley L. Stack, PH.D.
• Timothy H. Jones, M.D., Inc.

• Private Vehicle in Avila Beach, CA
• Providers in Avila Beach, CA by specialty
• Private Vehicle in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2022; 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.