Andrew Boyd Mavar, EMT-B

Individual provider Active NPI Basic Emergency Medical Technician · Helendale, CA

NPI 1477397602 · NPPES record last updated Jul 9, 2024

Key facts

NPI
1477397602
Entity type
Individual (NPI type 1)
Primary specialty
Basic Emergency Medical Technician 146N00000X
License
E168262 (CA)
Practice address
27535 Lakeview Dr Apt 36
Helendale, CA 92342-7858
Phone
(714) 650-4013
NPI assigned
Jun 22, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
E168262CAMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Onesource Search & Rescue, LLC Emergency Medical Technician, Basic Current
since Jul 7, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X E168262 CA Yes

Addresses

Primary practice location

27535 Lakeview Dr Apt 36
Helendale, CA 92342-7858

Mailing address

PO Box 3497
Helendale, CA 92342-3497
Phone (714) 650-4013

Other providers in Helendale, CA

All providers in Helendale, CA · Basic Emergency Medical Technician in California

Sources for this page

Verify at the official NPI Registry.