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General NPI Number Information
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NPI Number | 1033425475
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Entity Type | Organization
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Legal Business Name | ULTIMATE
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Dates
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Enumeration Date | 08/23/2010
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 6269 VARIEL AVE SUITE A
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-2527
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Country | US
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Telephone | 818-610-1717
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Fax | 818-610-1716
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Provider Business Mailing Address
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Address Line | 6269 VARIEL AVE SUITE A
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-2527
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Country | US
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Telephone | 818-610-1717
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Fax | 818-610-1716
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Authorized Official
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Title or Position | CEO
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Name | MR. NUBAR SHAKARYAN
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Credential |
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Telephone | 818-610-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 2039
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License Number State | CA
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