Provider Demographics
NPI:1194833939
Name:AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE, INC.
Entity type:Organization
Organization Name:AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-703-2294
Mailing Address - Street 1:PO BOX 55418
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-5418
Mailing Address - Country:US
Mailing Address - Phone:800-913-9106
Mailing Address - Fax:
Practice Address - Street 1:8808 BALBOA AVE STE 150
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-6502
Practice Address - Country:US
Practice Address - Phone:858-492-3500
Practice Address - Fax:858-492-3635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA180215101OtherWORKERS COMP DEPT OF LAB
CAMTE00093FMedicaid
CAZZZ37546ZOtherBS OF CA
CAMTE00093FOtherMOLINA HEALTH PLAN
CA010340OtherSCAN HEALTH PLAN
CA010340OtherSCAN HEALTH PLAN
CAMTE00093FMedicaid
CAZA361Medicare PIN