Citizens Medical Response, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

2097 Issued in CA

Legal business name

CITIZENS MEDICAL RESPONSE, LLC

Practice address

8030 Lorraine Ave
Suite 336
Stockton, CA 95210-4225

Phone

(800) 400-1248

Fax

(800) 828-3385

NPI assigned

Jan 16, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ivan Gaunder

Title

Managing Member

Phone

(800) 400-1248

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1134518996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8030 LORRAINE AVE",
            "address_2": "SUITE 336",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952104225",
            "telephone_number": "800-400-1248",
            "fax_number": "800-828-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8030 LORRAINE AVE",
            "address_2": "SUITE 336",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952104225",
            "telephone_number": "800-400-1248",
            "fax_number": "800-828-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITIZENS MEDICAL RESPONSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "GAUNDER",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "800-400-1248"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CA",
            "license": "2097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Stockton, CA
• Providers in Stockton, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.