Provider Demographics
NPI:1053581645
Name:SOTTEK TRIPPE ENTERPRISE, LLC
Entity type:Organization
Organization Name:SOTTEK TRIPPE ENTERPRISE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CORY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GRAHAM SOTTEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-579-0223
Mailing Address - Street 1:2105 CAMINO VIDA ROBLE
Mailing Address - Street 2:STE. A
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1460
Mailing Address - Country:US
Mailing Address - Phone:760-579-0223
Mailing Address - Fax:760-579-0240
Practice Address - Street 1:2105 CAMINO VIDA ROBLE
Practice Address - Street 2:STE. A
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1460
Practice Address - Country:US
Practice Address - Phone:760-579-0223
Practice Address - Fax:760-579-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance