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General NPI Number Information
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NPI Number | 1659655025
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Entity Type | Organization
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Legal Business Name | PIHI EMS URBAN AND WILDERNESS SEARCH AND RESCUE
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Dates
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Enumeration Date | 10/04/2011
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 8572 WESTERN AVE #9
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City | BUENA PARK
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State | CA
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Zip | 90620-3975
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Country | US
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Telephone | 562-631-9024
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Fax |
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Provider Business Mailing Address
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Address Line | 8572 WESTERN AVE #9
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City | BUENA PARK
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State | CA
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Zip | 90620-3975
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ CHIEF EXECUTIVE OFFICER
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Name | COREY RENE BROOKS
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Credential |
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Telephone | 562-631-9024
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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 | A6917547
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License Number State | CA
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