CALIFORNIA SHOCK TRAUMA AIR RESCUE (NPI# 1154408391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154408391 |
| Entity Type | Organization |
| Organization Name | CALIFORNIA SHOCK TRAUMA AIR RESCUE |
| Other Organization Name | CALSTAR |
| Practice Address |
4933 Bailey Loop Mcclellan CA 95652 |
| Practice Telephone | 9169214075 |
| Practice Fax Number | 9169214079 |
| Mailing Telephone | 9169214075 |
| Mailing Fax Number | 9169214079 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-02-07 |
| Authorized Official Name | JOSEPH F COOK (PRESIDENT & CEO) |
| Authorized Official Telephone | 9169214000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416A0800X |
Ambulance Specialization: Air Transport |
STRA2901 | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MTA00592F | 05 |
| Other Name | Type Code |
|---|---|
| CALSTAR | Doing Business As Name - Organization |
| Street Address |
4933 BAILEY LOOP |
| City | MCCLELLAN |
| State | CA |
| Zip Code | 95652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548688955 | Wenxia Han | Registered Nurse | 3401 Beech St, Bldg 949, Mcclellan, CA 95652 | 2014-04-02 |
| 1902231897 | Marisa Salas Silva | Social Worker | 3401 Beech Street, Bldg 949, Mcclellan, CA 95652 | 2013-09-10 |
| 1295070290 | Stephanie Ann Bost | Dietitian, Registered | 3401 Beech St., Mcclellan, CA 95652 | 2012-12-01 |
| 1811276025 | Brian C Choi | Dentist | 5401 Arnold Avenue, Bldg. 88, Sacramento, CA 95652 | 2011-08-05 |
| 1083704530 | Gerald Yang | Dentist | 5401 Arnold Avenue, Sacramento, CA 95652 | 2006-10-13 |
| 1104910652 | Ann Marie Mullen | Audiologist | 5342 Dudley Blvd., Sacramento, CA 95652 | 2006-10-02 |
| 1831174556 | Mark A Duckett | Dentist | 4101 Arnold Ave, Va /mcclellan Dental Service, Scramento, CA 95652 | 2005-12-15 |
| 1073596581 | Jane P Addagatla | Internal Medicine | Va Mcclellan Opc, 5342 Dudley Blvd,bldg 98, Mcclellan Park, CA 95652 | 2005-11-29 |
| 1528518321 | Dana Kirkwood Adkins | Social Worker | 3401 Beech Street, Building 949, Room #225, Mcclellan, CA 95652 | 2016-10-05 |
| 1457739328 | Julie Kirkes | Community/Behavioral Health | 5342 Dudley Blvd., Mccl/116, Mcclellan, CA 95652 | 2015-05-12 |
| Find all providers in zip 95652 | ||||
| Taxonomy Code | 3416A0800X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Air Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| 1104330646 | Mercy Air Service, Inc. | Ambulance | 545 Kenney St Ste G1a, El Cajon, CA 92020 | 2017-11-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.