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General NPI Number Information
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NPI Number | 1104924505
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Entity Type | Organization
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Legal Business Name | PROMED MEDICAL TRANSPORTATION INC. DBA PROMED AMBULANCE SERVICE
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15828 SOUTH BROADWAY ST., SUITE 'C'
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City | GARDENA
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State | CA
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Zip | 90248-2404
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Country | US
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Telephone | 310-767-1028
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Fax | 310-767-1058
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Provider Business Mailing Address
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Address Line | 15828 SOUTH BROADWAY ST., SUITE 'C'
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City | GARDENA
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State | CA
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Zip | 90248-2404
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Country | US
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Telephone | 310-767-1028
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Fax | 310-767-1058
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | ERIC FEINGOLD
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Credential |
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Telephone | 310-767-1028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 1846-8368
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License Number State | CA
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