Healthcare Provider Details

I. General information

NPI: 1558350140
Provider Name (Legal Business Name): BAKER EMERGENCY MEDICAL SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 12/16/2019
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 FRONT ST
NEEDLES CA
92363-2950
US

IV. Provider business mailing address

633 FRONT ST
NEEDLES CA
92363-2950
US

V. Phone/Fax

Practice location:
  • Phone: 760-326-5299
  • Fax: 760-326-4588
Mailing address:
  • Phone: 760-326-5299
  • Fax: 760-326-4588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL LOWENTHAL
Title or Position: DIRECTOR
Credential:
Phone: 760-326-5299