Provider Demographics
NPI:1356086813
Name:EMPIRE REAL ESTATE INVESTMENT GROUP
Entity Type:Organization
Organization Name:EMPIRE REAL ESTATE INVESTMENT GROUP
Other - Org Name:CALIFORNIA MEDICAL TRANSPORTATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROUSSARD
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:661-510-6524
Mailing Address - Street 1:3830 BELLEZA WAY
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551
Mailing Address - Country:US
Mailing Address - Phone:661-510-6524
Mailing Address - Fax:
Practice Address - Street 1:1008 W. AVE M14 SUITE A - D383
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-9355
Practice Address - Country:US
Practice Address - Phone:661-510-6524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)