City of San Rafael

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

CITY OF SAN RAFAEL

Practice address

1375 5TH Ave
San Rafael, CA 94901-1942

Phone

(415) 485-3084

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Darin White

Title

Fire Chief

Phone

(415) 485-3084

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1699832584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1330",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945854330",
            "telephone_number": "415-485-3304",
            "fax_number": "415-453-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 5TH AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011942",
            "telephone_number": "415-485-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF SAN RAFAEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DARIN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "415-485-3084"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE00308F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulance in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.