Provider Demographics
NPI:1831258730
Name:IMPERIAL AMBULANCE INC
Entity type:Organization
Organization Name:IMPERIAL AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FIORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-784-8500
Mailing Address - Street 1:22 N. COTTAGE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257
Mailing Address - Country:US
Mailing Address - Phone:559-784-8500
Mailing Address - Fax:559-782-5667
Practice Address - Street 1:22 N COTTAGE ST
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3220
Practice Address - Country:US
Practice Address - Phone:559-784-8500
Practice Address - Fax:559-782-5667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA809493416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31254ZMedicaid
CAZZZ31254ZMedicaid