Provider Demographics
NPI:1437112976
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:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-468-1612
Mailing Address - Street 1:7257 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5927
Mailing Address - Country:US
Mailing Address - Phone:619-583-0454
Mailing Address - Fax:619-465-1634
Practice Address - Street 1:7257 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-5927
Practice Address - Country:US
Practice Address - Phone:619-583-0454
Practice Address - Fax:619-465-1634
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
CAZZZ48538ZMedicaid
CAZZZ48538ZMedicaid
CAZA394Medicare PIN