Healthcare Provider Details

I. General information

NPI: 1639389554
Provider Name (Legal Business Name): JARBOU & JARBOU, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6975 NORTH AVE
LEMON GROVE CA
91945
US

IV. Provider business mailing address

6975 NORTH AVE
LEMON GROVE CA
91945
US

V. Phone/Fax

Practice location:
  • Phone: 619-589-0022
  • Fax: 619-589-0222
Mailing address:
  • Phone: 619-589-0022
  • Fax: 619-589-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberN630
License Number StateCA

VIII. Authorized Official

Name: MR. TOM DAOUD
Title or Position: PRESIDENT
Credential:
Phone: 619-589-0022