Ellen Medical Transport

Primary specialty

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

License

2017007484 Issued in CA

Legal business name

ELLEN MEDICAL TRANSPORT

Doing business as

Northside Medical Transport

Practice address

4587 Winona Ave #5
San Diego, CA 92115

Phone

(619) 315-1062

NPI assigned

Jul 3, 2017

Organization subpart

No

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

Authorized official

Name

Dawit Fesshaye

Title

C.E.O

Phone

(619) 315-1062

Specialties & licenses 1

Addresses

Other names 1

• Northside Medical Transport Doing business as

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982125605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4587 WINONA AVE APT 5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153339",
            "telephone_number": "619-315-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4587 WINONA AVE #5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92115",
            "telephone_number": "619-315-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLEN MEDICAL TRANSPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FESSHAYE",
        "authorized_official_first_name": "DAWIT",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "619-315-1062"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": "2017007484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northside Medical Transport",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northside Medical Transport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Marie Elkins, LCSW
• Shayna Elkins, FNP
• Elle Maternal Wellness, Nursing PC
• Daniel Kuroda Elledge, PHD
• Lindsay Elledge
• Rebecca Ann Ellens
• Adam Takeo Ellenthal, DDS, MPH
• Kandace Lyn Eller, GNP-BC
• Christopher Richard Elleraas, D.C.
• Karen Marie Ellerbrock, OTR/L

• Non-emergency Medical Transport (VAN) in San Diego, CA
• Providers in San Diego, 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 Jul 21, 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.