1467905604 NPI number — UTOPIA AMBULANCE TRANSPORTATION, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467905604 NPI number — UTOPIA AMBULANCE TRANSPORTATION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UTOPIA AMBULANCE TRANSPORTATION, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UTOPIA TRANSMPORTATION
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467905604
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2525 SOUTHPORT WAY STE P
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATIONAL CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91950-8590
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-434-2144
Provider Business Mailing Address Fax Number:
619-434-2474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2525 SOUTHPORT WAY STE P
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATIONAL CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91950-8590
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-434-2144
Provider Business Practice Location Address Fax Number:
619-434-2474
Provider Enumeration Date:
07/23/2016

Additional Information

Authorized Official

Authorized Official Last Name:
GEBREHIWOT
Authorized Official First Name:
HIRUT
Authorized Official Middle Name:
BEREKET
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
619-434-2144

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , with the licence number:  N861 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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