Provider Demographics
NPI:1518075449
Name:AMERICAN MEDICAL RESPONSE OF INLAND EMPIRE
Entity Type:Organization
Organization Name:AMERICAN MEDICAL RESPONSE OF INLAND EMPIRE
Other - Org Name:AMERICAN MEDICAL RESPONSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF REVENUE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-703-2294
Mailing Address - Street 1:PO BOX 55418
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-5418
Mailing Address - Country:US
Mailing Address - Phone:800-913-9106
Mailing Address - Fax:
Practice Address - Street 1:7925 CENTER AVE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3007
Practice Address - Country:US
Practice Address - Phone:909-477-5000
Practice Address - Fax:909-945-5183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA012482OtherSCAN HEALTH PLAN
CAMTE00994FOtherCALOPTIMA
CA197792100OtherWORKERS COMP DEPT OF LAB
CAMTE00994FOtherMOLINA HEALTH PLAN
CAZZZ56268ZOtherBS OF CA
CAMTE00994FMedicaid
CAMTE00994FOtherCALOPTIMA
CA012482OtherSCAN HEALTH PLAN
CAZZZ89604ZMedicare PIN