Provider Demographics
NPI:1235272071
Name:WESTERN MEDICAL SERVICES INC.
Entity Type:Organization
Organization Name:WESTERN MEDICAL SERVICES INC.
Other - Org Name:WESTERN MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LIDDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-782-7307
Mailing Address - Street 1:8745 PARTHENIA PL
Mailing Address - Street 2:STE#3
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-5157
Mailing Address - Country:US
Mailing Address - Phone:818-782-7307
Mailing Address - Fax:818-895-1713
Practice Address - Street 1:8745 PARTHENIA PL
Practice Address - Street 2:STE#3
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-5166
Practice Address - Country:US
Practice Address - Phone:818-782-7307
Practice Address - Fax:818-895-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTN00101F343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMCSUBB04OtherMEDI-CAL SUBMITTER NUMBER
CAMTN00101FOtherMEDI-CAL PROVIDER NUMBER