NPIMap

Organization Active NPI

County Service Area No 17

  • Land Ambulance
  • San Diego, CA
National Provider Identifier
1497024731
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
COUNTY SERVICE AREA NO 17
Practice address
5560 Overland Ave Ste 400
San Diego, CA 92123-1204
Phone
(858) 245-4231
NPI assigned
Dec 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Authorized official

Name
Andrew Dormann Parr
Title
EMS Administrator
Phone
(858) 245-4231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

5560 Overland Ave Ste 400
San Diego, CA 92123-1204

Mailing address

5560 Overland Avenue, Suite 400
San Diego, CA 92123-1204
Phone (858) 245-4231

Other names 1

  • CSA 17 SAN DIEGUITO AMBULANCE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120327000245 CA Part B Supplier - Ambulance Service Supplier 6002076239 Practice locations: Cardiff by the Sea, CA; Encinitas, CA; Rancho Santa Fe, CA; San Diego, CA; Solana Beach, CA

National Provider Directory

National Provider Directory

Locations

618 Birmingham Dr
Cardiff by the Sea, CA 92007
Phone (619) 285-6429

540 Balour Dr
Encinitas, CA 92024
Phone (619) 285-6429

5510 Overland Ave
Ste 250
San Diego, CA 92123
Phone (619) 285-6429

16930 Four Gee Rd
San Diego, CA 92127
Phone (619) 285-6429

5560 Overland Ave
Ste 400
San Diego, CA 92123
Phone (858) 245-4231

500 Lomas Santa Fe Dr
Solana Beach, CA 92075
Phone (619) 285-6429

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1497024731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 OVERLAND AVENUE, SUITE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231204",
            "telephone_number": "858-245-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5560 OVERLAND AVE STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231204",
            "telephone_number": "858-245-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY SERVICE AREA NO 17",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-15",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "PARR",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "DORMANN",
        "authorized_official_title_or_position": "EMS ADMINISTRATOR",
        "authorized_official_telephone_number": "858-245-4231"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSA 17 SAN DIEGUITO AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CSA 17 SAN DIEGUITO AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.