Provider Demographics
NPI:1760631618
Name:DIBIASSI CORP.
Entity Type:Organization
Organization Name:DIBIASSI CORP.
Other - Org Name:SOUTHERN CALIFORNIA AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-967-1322
Mailing Address - Street 1:5363 ALHAMBRA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-3411
Mailing Address - Country:US
Mailing Address - Phone:888-214-5263
Mailing Address - Fax:877-214-0066
Practice Address - Street 1:5363 ALHAMBRA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032-3411
Practice Address - Country:US
Practice Address - Phone:888-214-5263
Practice Address - Fax:877-214-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1924-10218341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance