Healthcare Provider Details

I. General information

NPI: 1225176050
Provider Name (Legal Business Name): ROYAL AMBULANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14472 WICKS BLVD
SAN LEANDRO CA
94577-6712
US

IV. Provider business mailing address

14472 WICKS BLVD
SAN LEANDRO CA
94577-6712
US

V. Phone/Fax

Practice location:
  • Phone: 510-568-6161
  • Fax: 510-568-6160
Mailing address:
  • Phone: 510-568-6161
  • Fax: 510-568-6160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1889
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVE GRAU
Title or Position: CEO/OWNER
Credential:
Phone: 510-568-6161