Organization
BALBOA AMBULANCE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN OLSON (ADMINISTRATOR)
(619) 440-9386
Entity
Organization
Contact information
Practice address
3550 AFTON RD, SAN DIEGO, CA 92123-2184
(858) 637-3524
(858) 284-9848
Mailing address
PO BOX 34577, SAN DIEGO, CA 92163-4577
(858) 637-3521
(858) 284-9848
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
115347
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-102
SAN DIEGO EMS PERMIT
CA
01
—
115347
CHP LICENSE
—
05
—
MTE00734F
—
CA
Enumeration date
08/05/2006
Last updated
12/18/2012
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