=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386803518
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CODE 3 RESPONSE CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2008
-----------------------------------------------------
Last Update Date | 06/03/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1845 N SAN FERNANDO RD
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90065-1227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-339-2468
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1845 N SAN FERNANDO RD
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90065-1227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-339-2468
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GEN MGR
-----------------------------------------------------
Name | MR. JACOB TCHAMANIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-339-2468
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------