Active NPI
Emergency Ambulance Service Inc
- Ambulance
- Brea, CA
National Provider Identifier
1376508366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- 23971
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ78586Z | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110623000354 | CA | Part B Supplier - Ambulance Service Supplier | 7719165695 | Practice locations: Brea, CA; Yorba Linda, CA |
National Provider Directory
National Provider DirectoryLocations
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.