Organization Active NPI

City of Manhattan Beach

  • Land Ambulance
  • Manhattan Beach, CA
National Provider Identifier
1043216740
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
CITY OF MANHATTAN BEACH
Practice address
1400 Highland Ave
Manhattan Beach, CA 90266-4756
Phone
(310) 802-5200
NPI assigned
Jun 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Authorized official

Name
Michael Lang
Title
Fire Chief
Phone
(310) 802-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

1400 Highland Ave
Manhattan Beach, CA 90266-4756

Mailing address

PO Box 269110
Sacramento, CA 95826-9110
Phone (800) 906-6552

Other identifiers 2

IdentifierTypeStateIssuer
590000740OtherRRB
ZZZ480442MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120315000599 CA Part B Supplier - Ambulance Service Supplier 5799713616 Practice locations: Manhattan Beach, CA

National Provider Directory

National Provider Directory

Locations

1400 Highland Ave
Manhattan Beach, CA 90266
Phone (310) 802-5200

400 15th St
Manhattan Beach, CA 90266

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1043216740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958269110",
            "telephone_number": "800-906-6552",
            "fax_number": "916-381-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HIGHLAND AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902664756",
            "telephone_number": "310-802-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MANHATTAN BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "310-802-5200"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "590000740",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ480442",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.