Provider Demographics
NPI:1336102870
Name:SCHAEFER AMBULANCE SERVICE
Entity Type:Organization
Organization Name:SCHAEFER AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-468-1612
Mailing Address - Street 1:PO BOX 74609
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-0609
Mailing Address - Country:US
Mailing Address - Phone:800-582-2258
Mailing Address - Fax:323-463-0433
Practice Address - Street 1:4627 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3101
Practice Address - Country:US
Practice Address - Phone:800-582-2258
Practice Address - Fax:323-463-0433
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCHAEFER AMBULANCE SERVICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE00748FMedicaid
CA590007364OtherRAILROAD PROVIDER NUMBER
CAMTE00748FMedicaid
CAZA372Medicare PIN