Healthcare Provider Details

I. General information

NPI: 1952607897
Provider Name (Legal Business Name): PROSPECTIVE AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2011
Last Update Date: 02/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15330 VERMONT AVE STE B
PARAMOUNT CA
90723-4225
US

IV. Provider business mailing address

15330 VERMONT AVE STE B
PARAMOUNT CA
90723-4225
US

V. Phone/Fax

Practice location:
  • Phone: 818-497-0555
  • Fax: 818-786-5559
Mailing address:
  • Phone: 818-497-0555
  • Fax: 818-786-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EMILIA ZVEREV
Title or Position: CEO
Credential:
Phone: 818-497-0555