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General NPI Number Information
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NPI Number | 1487733663
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Entity Type | Organization
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Legal Business Name | DESERT AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 03/06/2009
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Provider Practice Location Address
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Address Line | 831 W MAIN ST
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City | BARSTOW
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State | CA
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Zip | 92311-2649
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Country | US
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Telephone | 760-256-6854
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Fax | 760-256-1954
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Provider Business Mailing Address
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Address Line | 831 W MAIN ST
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City | BARSTOW
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State | CA
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Zip | 92311-2649
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Country | US
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Telephone | 760-256-6854
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Fax | 760-256-1954
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Authorized Official
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Title or Position | C.E.O.
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Name | MR. ELBERT W. MUNCY JR.
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Credential |
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Telephone | 760-256-6854
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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 | A188
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License Number State | CA
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