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General NPI Number Information
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NPI Number | 1407157209
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Entity Type | Organization
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Legal Business Name | STAR AMBULACE TRANSPORTATION
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 4500 S BUDLONG AVE
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City | LOS ANGELES
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State | CA
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Zip | 90037-2810
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Country | US
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Telephone | 323-309-0680
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 S BUDLONG AVE
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City | LOS ANGELES
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State | CA
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Zip | 90037-2810
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Country | US
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Telephone | 323-309-0680
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERICA CARTER
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Credential |
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Telephone | 323-309-0680
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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 | 3323372
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License Number State | CA
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