MEDICARE: MAX LAUFER INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance		CA

General Provider Information

NPI Number	:	1407178585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAX LAUFER INC.

Provider Business Mailing Address
First Line	:	7614 LEMON AVE
Second Line	:
City	:	LEMON GROVE
State	:	CA
Zip	:	91945-1619
Country	:	US
Telephone Number	:	310-418-9618
Fax Number	:

Provider Business Practice Location Address
First Line	:	7614 LEMON AVE.
Second Line	:
City	:	LEMON GROVE
State	:	CA
Zip	:	91945-1619
Country	:	US
Telephone Number	:	310-418-9618
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MAX LAUFER
Credential	:
Telephone Number	:	310-418-9618

Provider Enumeration Date	:	02/17/2010
Last Update Date	:	02/17/2010

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