Healthcare Provider Details

I. General information

NPI: 1962733402
Provider Name (Legal Business Name): RESCUE ONE AMBULANCE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 11/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15540 TEXACO AVE
PARAMOUNT CA
90723-3922
US

IV. Provider business mailing address

15540 TEXACO AVE
PARAMOUNT CA
90723-3922
US

V. Phone/Fax

Practice location:
  • Phone: 877-220-0421
  • Fax: 877-330-3520
Mailing address:
  • Phone: 877-220-0421
  • Fax: 877-330-3520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW AYAD BOULOS
Title or Position: C.E.O.
Credential:
Phone: 562-252-2010