Healthcare Provider Details

I. General information

NPI: 1992670418
Provider Name (Legal Business Name): CALSTATE EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 N LINCOLN ST
BURBANK CA
91504-3334
US

IV. Provider business mailing address

2019 N LINCOLN ST
BURBANK CA
91504-3334
US

V. Phone/Fax

Practice location:
  • Phone: 818-858-8480
  • Fax: 888-543-9468
Mailing address:
  • Phone: 818-858-8480
  • Fax: 888-543-9468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: JOE MKHITARYAN
Title or Position: COO
Credential:
Phone: 818-858-8480