Provider Demographics
NPI:1407340870
Name:SAN DIEGO AMBULANCE LLC
Entity Type:Organization
Organization Name:SAN DIEGO AMBULANCE LLC
Other - Org Name:SAN DIEGO AMBULANCE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOURHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOULAQA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-399-0006
Mailing Address - Street 1:8534 COMMERCE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2600
Mailing Address - Country:US
Mailing Address - Phone:619-399-0006
Mailing Address - Fax:
Practice Address - Street 1:8534 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2600
Practice Address - Country:US
Practice Address - Phone:619-399-0006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21653416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport