Provider Demographics
NPI:1235502949
Name:INTEL HEALTHCARE LLC
Entity Type:Organization
Organization Name:INTEL HEALTHCARE LLC
Other - Org Name:INTEL AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MIKELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-833-5608
Mailing Address - Street 1:712 N VALLEY ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-3828
Mailing Address - Country:US
Mailing Address - Phone:714-833-5608
Mailing Address - Fax:714-833-5592
Practice Address - Street 1:712 N VALLEY ST
Practice Address - Street 2:SUITE C
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-3828
Practice Address - Country:US
Practice Address - Phone:714-833-5608
Practice Address - Fax:714-833-5592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance