Organization Active NPI

City of Brea

  • Land Ambulance
  • Brea, CA
National Provider Identifier
1104688993
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
CITY OF BREA
Practice address
1 Civic Center Cir
Brea, CA 92821-5792
Phone
(714) 990-7655
NPI assigned
Jan 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
William Gallardo Jr.
Title
City Manager
Phone
(714) 990-7710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

1 Civic Center Cir
Brea, CA 92821-5792

Mailing address

PO Box 269110
Sacramento, CA 95826-9110
Phone (916) 669-4607

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240423000541 CA Part B Supplier - Ambulance Service Supplier 5698114775 Practice locations: Brea, CA

National Provider Directory

National Provider Directory

Locations

200 N Brea Blvd
Brea, CA 92821
Phone (714) 990-7655

149 W Lambert Rd
Brea, CA 92821
Phone (562) 665-7293

555 N Berry St
Brea, CA 92821
Phone (714) 790-7655

198 Olinda Pl
Brea, CA 92823
Phone (714) 990-7655

NPI Registry JSON

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1104688993",
    "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": "916-669-4607",
            "fax_number": "916-471-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CIVIC CENTER CIR",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215792",
            "telephone_number": "714-990-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BREA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "GALLARDO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CITY MANAGER",
        "authorized_official_telephone_number": "714-990-7710",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.