Healthcare Provider Details
I. General information
NPI: 1013600964
Provider Name (Legal Business Name): ELITE AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/29/2023
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2304 WHIPPLE AVE
REDWOOD CITY CA
94062-2148
US
IV. Provider business mailing address
2304 WHIPPLE AVE
REDWOOD CITY CA
94062-2148
US
V. Phone/Fax
- Phone: 650-784-5481
- Fax:
- Phone: 650-784-5481
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AYAT
DABIT
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 650-784-5481