Healthcare Provider Details

I. General information

NPI: 1932292604
Provider Name (Legal Business Name): AMERICAN MEDICAL RESPONSE OF SOUTHERN CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5257 VINCENT AVE
IRWINDALE CA
91706-2042
US

IV. Provider business mailing address

PO BOX 55418
LOS ANGELES CA
90074-5418
US

V. Phone/Fax

Practice location:
  • Phone: 626-633-4600
  • Fax: 626-633-4609
Mailing address:
  • Phone: 800-913-9106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY JOSEPH DORN
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 833-703-2294