| Organization Name: | SHORELINE AMBULANCE COMPANY, LLC |
| NPI Number: | 1033401005 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SAMUEL HAUPTMAN (OWNER) |
| Mailing Address: | 17762 Metzler Ln Huntington Beach |
| State: | CA US |
| Postal Code: | 926476245 |
| Phone Number: | 7148479107 |
| Fax Number: | 7148486943 |
| NPI Enumeration Date: | 05/10/2011 |
| NPI Last Update Date: | 01/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |