Provider Demographics
NPI:1205973591
Name:CRITICAL AIR MEDICINE
Entity type:Organization
Organization Name:CRITICAL AIR MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PBO SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSMUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-883-2399
Mailing Address - Street 1:13400 SABRE SPRINGS PKWY STE 270
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-8103
Mailing Address - Country:US
Mailing Address - Phone:858-883-2399
Mailing Address - Fax:
Practice Address - Street 1:13400 SABRE SPRINGS PKWY STE 270
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-8103
Practice Address - Country:US
Practice Address - Phone:858-883-2399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIBUA121E3416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTA00591FMedicaid
TX516064Medicare ID - Type UnspecifiedTEXAS MEDICARE