City of Coronado

Organization Active NPI Land Ambulance · Coronado, CA

NPI 1487650602 · NPPES record last updated Oct 17, 2007

Key facts

NPI
1487650602
Entity type
Organization (NPI type 2)
Primary specialty
Land Ambulance 3416L0300X
Legal business name
CITY OF CORONADO
Practice address
1001 6TH St
Coronado, CA 92118-1711
Phone
(619) 522-7374
NPI assigned
Jun 22, 2005
Organization subpart
No

Authorized official

Name
Dan Matstro
Title
Fire Chirf
Phone
(619) 522-7374

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090521000524 CA Part B Supplier - Ambulance Service Supplier 2163571159 Practice locations: Coronado, CA

National Provider Directory

Locations

1001 6th St
Coronado, CA 92118
Phone (619) 522-2496

101 Grand Caribe Cswy
Coronado, CA 92118
Phone (619) 522-2496

1825 Strand Way
Coronado, CA 92118
Phone (619) 522-7306

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Yes

Addresses

Primary practice location

1001 6TH St
Coronado, CA 92118-1711

Mailing address

PO Box 269110
Sacramento, CA 95826-9110

Other identifiers

IdentifierTypeStateIssuer
ZZZ70368ZMedicaidCA

Other providers in Coronado, CA

All providers in Coronado, CA · Land Ambulance in California

Sources for this page

Verify at the official NPI Registry.