Organization
MISSION AMBULANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL GILLES GOLD (PRESIDENT)
(951) 808-8758
Entity
Organization
Contact information
Practice address
1055 E 3RD ST, CORONA, CA 92879-1606
(951) 808-8758
(951) 808-8730
Mailing address
PO BOX 3111, CORONA, CA 92878-3111
(951) 808-8758
(951) 808-8730
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
C2221622
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MTE01116F
—
CA
01
—
ZZZ04700Z
BLUE SHIELD
CA
Enumeration date
07/04/2006
Last updated
08/22/2020
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