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General NPI Number Information
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NPI Number | 1598084162
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Entity Type | Organization
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Legal Business Name | BRAVO CARE INC
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Dates
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Enumeration Date | 05/21/2010
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 8522 FOOTHILL BLVD SUITE 206
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City | SUNLAND
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State | CA
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Zip | 91040-1912
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Country | US
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Telephone | 818-352-7208
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Fax | 818-352-7302
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Provider Business Mailing Address
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Address Line | 8522 FOOTHILL BLVD SUITE 206
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City | SUNLAND
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State | CA
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Zip | 91040-1912
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Country | US
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Telephone | 818-352-7208
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Fax | 818-352-7302
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Authorized Official
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Title or Position | CEO
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Name | MATSAK ADIKYAN
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Credential |
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Telephone | 818-352-7208
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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 | 2019
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License Number State | CA
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