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General NPI Number Information
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NPI Number | 1366760951
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Entity Type | Organization
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Legal Business Name | SEDA CARE INC
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 06/28/2010
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Provider Practice Location Address
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Address Line | 6117 RESEDA BLVD SUITE 207
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City | TARZANA
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State | CA
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Zip | 91335-7359
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Country | US
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Telephone | 818-705-3005
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Fax | 818-705-3006
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Provider Business Mailing Address
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Address Line | 6117 RESEDA BLVD SUITE 207
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City | TARZANA
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State | CA
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Zip | 91335-7359
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Country | US
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Telephone | 818-705-3005
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Fax | 818-705-3006
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Authorized Official
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Title or Position | CEO
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Name | ALEXANDER SEMIBRATOV
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Credential |
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Telephone | 818-705-3005
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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 | 2018
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License Number State | CA
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