Obsidian

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

OBSIDIAN

Doing business as

Empower Ambulance Company

Practice address

2030 Eucalyptus Ave
Long Beach, CA 90806-4606

Phone

(323) 804-3031

NPI assigned

Oct 2, 2014

Last updated

Oct 14, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Derrick Marlin Myers, M.D.

Title

President/Ceo

Phone

(323) 804-3031

Specialties & licenses 1

Addresses

Other names 1

• Empower Ambulance Company Doing business as

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413244800000",
    "number": "1396148524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 E. WILLOW ST. STE D #259",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907552142",
            "telephone_number": "323-804-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 EUCALYPTUS AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908064606",
            "telephone_number": "323-804-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSIDIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-14",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "MARLIN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "323-804-3031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Empower Ambulance Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Non-emergency Medical Transport (VAN) in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Non-emergency Medical Transport (VAN) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.