Provider Demographics
NPI:1972738789
Name:ASA'S RESPIRATORY CARE SERVICE'S
Entity type:Organization
Organization Name:ASA'S RESPIRATORY CARE SERVICE'S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASA
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RCP
Authorized Official - Phone:951-224-2607
Mailing Address - Street 1:124 W FOOTHILL BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-5072
Mailing Address - Country:US
Mailing Address - Phone:951-224-2607
Mailing Address - Fax:
Practice Address - Street 1:124 W FOOTHILL BLVD STE B
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-5072
Practice Address - Country:US
Practice Address - Phone:951-224-2607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0009856227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGOtherMEDICARE PIN NUMBER PENDING