Healthcare Provider Details

I. General information

NPI: 1871110601
Provider Name (Legal Business Name): RICHARD FOX EMMONS JR. EMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2020
Last Update Date: 06/27/2020
Certification Date: 06/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4470 W SUNSET BLVD STE 700
LOS ANGELES CA
90027-6068
US

IV. Provider business mailing address

4470 W SUNSET BLVD STE 700
LOS ANGELES CA
90027-6068
US

V. Phone/Fax

Practice location:
  • Phone: 323-273-0288
  • Fax:
Mailing address:
  • Phone: 323-273-0288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE073900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: