Provider Demographics
NPI:1558350140
Name:BAKER EMERGENCY MEDICAL SERVICE, INC
Entity Type:Organization
Organization Name:BAKER EMERGENCY MEDICAL SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-326-5299
Mailing Address - Street 1:633 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:NEEDLES
Mailing Address - State:CA
Mailing Address - Zip Code:92363-2950
Mailing Address - Country:US
Mailing Address - Phone:760-326-5299
Mailing Address - Fax:760-326-4588
Practice Address - Street 1:633 FRONT ST
Practice Address - Street 2:
Practice Address - City:NEEDLES
Practice Address - State:CA
Practice Address - Zip Code:92363-2950
Practice Address - Country:US
Practice Address - Phone:760-326-5299
Practice Address - Fax:760-326-4588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE00703FMedicaid
CAMTE00703FMedicaid
CAZZZ38890ZMedicare PIN