Provider Demographics
NPI:1639131436
Name:FALCK MOBILE HEALTH CORP
Entity Type:Organization
Organization Name:FALCK MOBILE HEALTH CORP
Other - Org Name:CARE AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF LEGAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-478-8318
Mailing Address - Street 1:PO BOX 31001-2183
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91110-2183
Mailing Address - Country:US
Mailing Address - Phone:714-288-3800
Mailing Address - Fax:714-288-3889
Practice Address - Street 1:1517 W BRADEN CT
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1125
Practice Address - Country:US
Practice Address - Phone:714-288-3800
Practice Address - Fax:714-288-3889
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FALCK USA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-05
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA658003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE00382FMedicaid
CAP00154125OtherPALMETTO RAILROAD MEDICAR
CAZA436Medicare UPIN