Healthcare Provider Details

I. General information

NPI: 1730480682
Provider Name (Legal Business Name): STAT RESPONSE AMBULANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 YORK BLVD.
LOS ANGELES CA
90042
US

IV. Provider business mailing address

4750 YORK BLVD.
LOS ANGELES CA
90042
US

V. Phone/Fax

Practice location:
  • Phone: 323-747-0057
  • Fax: 714-996-2135
Mailing address:
  • Phone: 323-747-0057
  • Fax: 714-996-2135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
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 Number
License Number State

VIII. Authorized Official

Name: MR. ALEX PUNZALAN ALINO
Title or Position: PRESIDENT, CEO
Credential:
Phone: 714-600-4915