Organization Active NPI

Emergency Ambulance Service Inc

  • Ambulance
  • Brea, CA
National Provider Identifier
1376508366
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
23971 Issued in CA
Legal business name
EMERGENCY AMBULANCE SERVICE INC
Practice address
3200 E Birch St
Suite a
Brea, CA 92821-6258
Phone
(714) 990-1742
Fax
(714) 792-3650
NPI assigned
Apr 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Philip E Davis, PRESIDENT
Title
President
Phone
(714) 990-1742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 23971 CA Primary

Addresses

Primary practice location

3200 E Birch St
Suite a
Brea, CA 92821-6258

Mailing address

3200 E Birch St
Suite a
Brea, CA 92821-6258
Phone (714) 990-1742

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ78586ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110623000354 CA Part B Supplier - Ambulance Service Supplier 7719165695 Practice locations: Brea, CA; Yorba Linda, CA

National Provider Directory

National Provider Directory

Locations

3200 E Birch St
Ste A
Brea, CA 92821
Phone (714) 986-3930

419 W Chapman Ave
Ste D
Placentia, CA 92870
Phone (714) 792-0425

22603 La Palma Ave
Ste 300
Yorba Linda, CA 92887
Phone (714) 990-1742

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376508366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E BIRCH ST",
            "address_2": "SUITE A",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216258",
            "telephone_number": "714-990-1742",
            "fax_number": "714-792-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 E BIRCH ST",
            "address_2": "SUITE A",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216258",
            "telephone_number": "714-990-1742",
            "fax_number": "714-792-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-990-1742",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "CA",
            "license": "23971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ78586Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.