Eagle Ambulance

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

EAGLE AMBULANCE

Practice address

333 Hegenberger Rd Ste 855
Oakland, CA 94621-1416

Phone

(510) 452-1100

Fax

(510) 452-1110

NPI assigned

Nov 29, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Allan Ray Bulda

Title

Co-Owner

Phone

(650) 291-2342

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": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1386114643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 HEGENBERGER RD STE 855",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946211416",
            "telephone_number": "510-452-1100",
            "fax_number": "510-452-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 HEGENBERGER RD STE 855",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946211416",
            "telephone_number": "510-452-1100",
            "fax_number": "510-452-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "BULDA",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "650-291-2342",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulance in Oakland, CA
• Providers in Oakland, CA by specialty
• Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.