Medic-1 Ambulance Service Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1822 Issued in CA

Legal business name

MEDIC-1 AMBULANCE SERVICE INC.

Practice address

5462 Irwindale Ave
Ste B
Irwindale, CA 91706-2074

Phone

(626) 385-0440

Fax

(626) 815-2852

NPI assigned

Jun 30, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gordon Shipp

Title

Ceo/ President

Phone

(626) 385-0440

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248825600000",
    "number": "1518964022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5462 IRWINDALE AVE",
            "address_2": "STE B",
            "city": "IRWINDALE",
            "state": "CA",
            "postal_code": "917062074",
            "telephone_number": "626-385-0440",
            "fax_number": "626-815-2852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5462 IRWINDALE AVE",
            "address_2": "STE B",
            "city": "IRWINDALE",
            "state": "CA",
            "postal_code": "917062074",
            "telephone_number": "626-385-0440",
            "fax_number": "626-815-2852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIC-1 AMBULANCE SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2009-07-29",
        "status": "A",
        "authorized_official_last_name": "SHIPP",
        "authorized_official_first_name": "GORDON",
        "authorized_official_title_or_position": "CEO/ PRESIDENT",
        "authorized_official_telephone_number": "626-385-0440",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CA",
            "license": "1822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE01065F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIF. CORPORATION #",
            "identifier": "2368718",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHP LICENSE #",
            "identifier": "1822",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Irwindale, CA
• Providers in Irwindale, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.