Healthcare Provider Details

I. General information

NPI: 1790064608
Provider Name (Legal Business Name): UNITED PLUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2011
Last Update Date: 08/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 CHESS DR SUITE E
FOSTER CITY CA
94404-1194
US

IV. Provider business mailing address

1161 CHESS DR SUITE E
FOSTER CITY CA
94404-1194
US

V. Phone/Fax

Practice location:
  • Phone: 650-525-1295
  • Fax: 650-525-1155
Mailing address:
  • Phone: 650-525-1295
  • Fax: 650-525-1155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number110001024B
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number110001024B
License Number StateCA

VIII. Authorized Official

Name: CHRISTOPHER MOESSMER
Title or Position: OWNER
Credential:
Phone: 650-525-1295