Provider Demographics
NPI:1194833939
Name:AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE, INC.
Entity type:Organization
Organization Name:AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DORN
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 1:8808 BALBOA AVE STE 150
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-6502
Practice Address - Country:US
Practice Address - Phone:858-492-3500
Practice Address - Fax:858-492-3635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1194833939Medicaid
AZ188266Medicaid
CAZZZ37546ZOtherBS OF CA
CAMTE00093FOtherMOLINA HEALTH PLAN
CA010340OtherSCAN HEALTH PLAN
CA010340OtherSCAN HEALTH PLAN
CAMTE00093FMedicaid
CAZA361Medicare PIN