Provider Demographics
NPI:1861419798
Name:CARAMEDIX, INC.
Entity type:Organization
Organization Name:CARAMEDIX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NILO
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-926-1980
Mailing Address - Street 1:15421 CARMENITA RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-5651
Mailing Address - Country:US
Mailing Address - Phone:562-926-1980
Mailing Address - Fax:562-404-9115
Practice Address - Street 1:15421 CARMENITA RD
Practice Address - Street 2:SUITE L
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-5651
Practice Address - Country:US
Practice Address - Phone:562-926-1980
Practice Address - Fax:562-404-9115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3439000000X343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN00526FMedicaid