Provider Demographics
NPI:1306026612
Name:PATRIOT AMBULANCE INC.
Entity Type:Organization
Organization Name:PATRIOT AMBULANCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:AFZALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-877-3050
Mailing Address - Street 1:1750 S LA CIENEGA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4602
Mailing Address - Country:US
Mailing Address - Phone:310-877-3050
Mailing Address - Fax:
Practice Address - Street 1:13437 INGLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5653
Practice Address - Country:US
Practice Address - Phone:310-877-3050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport