Provider Demographics
NPI:1417975236
Name:MEDIX AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:MEDIX AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-470-8921
Mailing Address - Street 1:26021 PALA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2705
Mailing Address - Country:US
Mailing Address - Phone:949-470-8921
Mailing Address - Fax:
Practice Address - Street 1:26021 PALA
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2705
Practice Address - Country:US
Practice Address - Phone:949-470-8921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE00375FMedicaid
CAMTE00375FMedicaid