Healthcare Provider Details

I. General information

NPI: 1477848869
Provider Name (Legal Business Name): AMERICAN PARAMED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2011
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3817 RUFFED GROUSE LN
MODESTO CA
95355-8506
US

IV. Provider business mailing address

3817 RUFFED GROUSE LN
MODESTO CA
95355-8506
US

V. Phone/Fax

Practice location:
  • Phone: 209-846-4270
  • Fax: 209-551-1253
Mailing address:
  • Phone: 209-846-4270
  • Fax: 209-551-1253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberCPT00017343
License Number StateCA

VIII. Authorized Official

Name: MRS. NICHOLE ANN ENRIQUEZ
Title or Position: OWNER/PARAMEDICAL EXAMINER/PHLEBO
Credential: CPT-1
Phone: 209-846-4270