Healthcare Provider Details

I. General information

NPI: 1417975236
Provider Name (Legal Business Name): MEDIX AMBULANCE SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26021 PALA
MISSION VIEJO CA
92691-2705
US

IV. Provider business mailing address

26021 PALA
MISSION VIEJO CA
92691-2705
US

V. Phone/Fax

Practice location:
  • Phone: 949-470-8921
  • Fax:
Mailing address:
  • Phone: 949-470-8921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL DIMAS
Title or Position: PRESIDENT
Credential:
Phone: 949-470-8921