Eastlake Transport LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

EASTLAKE TRANSPORT LLC

Practice address

12711 Snake River Dr
Victorville, CA 92392-6196

Phone

(323) 697-0005

NPI assigned

May 3, 2024

Organization subpart

No

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

Authorized official

Name

Jesse MoralesNPI 1669250114

Title

Owner

Phone

(323) 697-0005

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesse Morales

  • Non-emergency Medical Transport (VAN)
  • Victorville, CA
  • NPI 1669250114
  NPD Authorized official

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1841047289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12711 SNAKE RIVER DR",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923926196",
            "telephone_number": "323-697-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12711 SNAKE RIVER DR",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923926196",
            "telephone_number": "323-697-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTLAKE TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-697-0005"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• E.V.a. Health LLC
• Leslie Diane Earl
• Charmaine Elizabeth Earle, MD
• Kaila M Eastburn
• Ronni Marie Eastburn
• Patricia Jane Ebbecke, NP
• Alexyss Echeverria
• Valerie Samantha Echeverria, RADT
• Ashley Eddy
• Edgard M Vera MD Inc

• Non-emergency Medical Transport (VAN) in Victorville, CA
• Providers in Victorville, CA by specialty
• Non-emergency Medical Transport (VAN) in California

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