City of Indio

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF INDIO

Doing business as

City of Indio Fire Department

Practice address

46990 Jackson St
Indio, CA 92201-6042

Phone

(760) 347-0756

NPI assigned

Jun 24, 2005

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Rockwell

Title

Asst City Manager/Finance Directot

Phone

(760) 391-4029

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• City of Indio Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1013913946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2066",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922022066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46990 JACKSON ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016042",
            "telephone_number": "760-347-0756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Civic Center Mall",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922014434",
            "country_code": "US",
            "telephone_number": "760-391-4115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CITY OF INDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "ROCKWELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "ASST CITY MANAGER/FINANCE DIRECTOT",
        "authorized_official_telephone_number": "760-391-4029"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "590003314",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE00228F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Indio Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Maria Terriquez Chuo, M.S.
• Annamaria T Church, MD
• Elsa Minnie Cisneros
• Courtney Ellisse Clark
• Henry R Clark
• Monica Clark
• Monica Clark
• Gilda Carlin Clarke

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.