1477738755 NPI number — MED-LIFE AMBULANCE SERVICES,INC.

Table of content: (NPI 1477738755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477738755 NPI number — MED-LIFE AMBULANCE SERVICES,INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MED-LIFE AMBULANCE SERVICES,INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477738755
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4525
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91222-0525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-500-0044
Provider Business Mailing Address Fax Number:
818-500-9992

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5304 SAN FERNANDO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91203-2407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-500-0044
Provider Business Practice Location Address Fax Number:
818-500-9992
Provider Enumeration Date:
01/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SEYSYAN
Authorized Official First Name:
SHAKE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
818-500-0044

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com