Provider Demographics
NPI:1477848869
Name:AMERICAN PARAMED
Entity Type:Organization
Organization Name:AMERICAN PARAMED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARAMEDICAL EXAMINER/PHLEBO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CPT-1
Authorized Official - Phone:209-846-4270
Mailing Address - Street 1:3817 RUFFED GROUSE LN
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-8506
Mailing Address - Country:US
Mailing Address - Phone:209-846-4270
Mailing Address - Fax:209-551-1253
Practice Address - Street 1:3817 RUFFED GROUSE LN
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-8506
Practice Address - Country:US
Practice Address - Phone:209-846-4270
Practice Address - Fax:209-551-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT00017343247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty