Healthcare Provider Details

I. General information

NPI: 1992540819
Provider Name (Legal Business Name): ONESOURCE SEARCH & RESCUE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27535 LAKEVIEW DR APT 36
HELENDALE CA
92342-7858
US

IV. Provider business mailing address

PO BOX 3497
HELENDALE CA
92342-3497
US

V. Phone/Fax

Practice location:
  • Phone: 714-650-4013
  • Fax:
Mailing address:
  • Phone: 714-650-4013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW BOYD MAVAR
Title or Position: OWNER
Credential: EMT-B
Phone: 714-650-4013