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General NPI Number Information
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NPI Number | 1255576807
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Entity Type | Organization
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Legal Business Name | OUR HOUSE TRANSPORTATION
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 12/11/2008
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Provider Practice Location Address
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Address Line | 1123 E DOMINGUEZ ST. SUITE B & C
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City | CARSON
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State | CA
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Zip | 90746
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Country | US
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Telephone | 310-763-4998
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Fax | 310-886-3064
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Provider Business Mailing Address
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Address Line | 1123 E DOMINGUEZ ST. SUITE B & C
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City | CARSON
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State | CA
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Zip | 90746
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Country | US
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Telephone | 310-763-4998
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Fax | 310-886-3064
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BARBARA W. SHALWAN
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Credential |
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Telephone | 310-763-4998
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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 | T66729
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License Number State | CA
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