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General NPI Number Information
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NPI Number | 1508994823
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Entity Type | Organization
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Legal Business Name | SACRAMENTO VALLEY AMBULANCE INC.
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 6220 BELLEAU WOOD LN SUITE 4
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City | SACRAMENTO
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State | CA
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Zip | 95822-5922
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Country | US
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Telephone | 916-422-3881
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Fax | 916-422-3866
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Provider Business Mailing Address
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Address Line | 6220 BELLEAU WOOD LN SUITE 4
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City | SACRAMENTO
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State | CA
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Zip | 95822-5922
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Country | US
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Telephone | 916-422-3881
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Fax | 916-422-3866
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Authorized Official
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Title or Position | CEO
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Name | MR. PAUL JAMES LAKICH
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Credential | PARAMEDIC
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Telephone | 916-422-3881
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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 | 2932337
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License Number State | CA
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