City of El Segundo

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF EL SEGUNDO

Practice address

350 Main St
El Segundo, CA 90245-3813

Phone

(310) 524-2236

NPI assigned

Jun 23, 2005

Organization subpart

No

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

Authorized official

Name

Christopher Donovan

Title

Fire Chief

Phone

(310) 524-2219

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1119484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1548266604",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MAIN ST",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453813",
            "telephone_number": "310-524-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF EL SEGUNDO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-23",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "DONOVAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "310-524-2219"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE01042F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "590015389",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Marie Church
• Michael Cicelski
• Kelly Cicotte, PA-C
• Natalie Cieslar
• Cig Group, LLC.
• Bea Clarisse Santos
• Alec Clark
• Charles Clark
• Hailey Clark
• Jade Clark

• Land Ambulance in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.