Provider Demographics
NPI:1376508366
Name:EMERGENCY AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:EMERGENCY AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:714-990-1742
Mailing Address - Street 1:3200 E BIRCH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-6258
Mailing Address - Country:US
Mailing Address - Phone:714-990-1742
Mailing Address - Fax:714-792-3650
Practice Address - Street 1:3200 E BIRCH ST
Practice Address - Street 2:SUITE A
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-6258
Practice Address - Country:US
Practice Address - Phone:714-990-1742
Practice Address - Fax:714-792-3650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23971341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ78586ZMedicaid
ZA314Medicare ID - Type Unspecified