Provider Demographics
NPI:1760694897
Name:ER AMBULANCE
Entity Type:Organization
Organization Name:ER AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:443-271-9497
Mailing Address - Street 1:1365 JOHNSON AVE.
Mailing Address - Street 2:SUITE 116
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-1649
Mailing Address - Country:US
Mailing Address - Phone:619-401-9900
Mailing Address - Fax:619-401-9911
Practice Address - Street 1:1365 JOHNSON AVE.
Practice Address - Street 2:SUITE 116
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1649
Practice Address - Country:US
Practice Address - Phone:619-401-9900
Practice Address - Fax:619-401-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1865341600000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZ558Medicare PIN