Professional Healthcare Associates, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

PROFESSIONAL HEALTHCARE ASSOCIATES, INC.

Practice address

423 Jenks Cir
Corona, CA 92878-5039

Phone

(951) 278-3700

Fax

(951) 736-1933

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Deborah Ruiz

Title

Vice President

Phone

(951) 278-3700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cavalry Ambulance Doing business as

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": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1609912419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 JENKS CIR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928785039",
            "telephone_number": "951-278-3700",
            "fax_number": "951-736-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 JENKS CIR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928785039",
            "telephone_number": "951-278-3700",
            "fax_number": "951-736-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HEALTHCARE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "951-278-3700"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMBER",
            "identifier": "ZZZ13518Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cavalry Ambulance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cavalry Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Corona, CA
• Providers in Corona, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.