Healthcare Provider Details

I. General information

NPI: 1730505926
Provider Name (Legal Business Name): AMERICAN MED AMBULANCE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2014
Last Update Date: 03/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 W WARNER AVE
SANTA ANA CA
92704-5219
US

IV. Provider business mailing address

3750 W WARNER AVE
SANTA ANA CA
92704-5219
US

V. Phone/Fax

Practice location:
  • Phone: 714-710-8888
  • Fax:
Mailing address:
  • Phone: 714-710-8888
  • Fax: 714-850-1240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. SUSANNA KHACHATRIAN
Title or Position: PRESIDENT
Credential:
Phone: 714-710-8888