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General NPI Number Information
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NPI Number | 1093176315
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Entity Type | Organization
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Legal Business Name | COUNTRY GUIDE & CARE
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Dates
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Enumeration Date | 03/14/2016
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 16038 SPRINGDALE ST D#7
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-1778
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Country | US
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Telephone | 562-303-6653
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Fax | 657-244-8007
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Provider Business Mailing Address
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Address Line | 16038 SPRINGDALE ST D#7
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-1778
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PETER AWAD
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Credential |
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Telephone | 562-303-6653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | D6124591
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License Number State | CA
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