Healthcare Provider Details

I. General information

NPI: 1740334259
Provider Name (Legal Business Name): ENOVA MEDICAL RESPONSE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 W TEMPLE ST 2ND FLOOR
LOS ANGELES CA
90026-5612
US

IV. Provider business mailing address

1227 W TEMPLE ST 2ND FLOOR
LOS ANGELES CA
90026-5612
US

V. Phone/Fax

Practice location:
  • Phone: 213-482-9654
  • Fax: 213-482-9658
Mailing address:
  • Phone: 213-482-9654
  • Fax: 213-482-9658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0002026160-0001-4
License Number StateCA

VIII. Authorized Official

Name: MR. DAVID MALINTSYAN
Title or Position: PRESIDENT - CEO
Credential:
Phone: 213-482-9654