Provider Demographics
NPI:1144792011
Name:CCHP EMS CA
Entity Type:Organization
Organization Name:CCHP EMS CA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-225-0350
Mailing Address - Street 1:700 CENTRAL EXPY S STE 400
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8113
Mailing Address - Country:US
Mailing Address - Phone:866-225-0350
Mailing Address - Fax:818-462-0991
Practice Address - Street 1:1081 N CHINA LAKE BLVD
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3130
Practice Address - Country:US
Practice Address - Phone:760-446-3551
Practice Address - Fax:818-462-0991
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAWRENCE A BEAN MD CCHP EMS CA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty