City of la Verne

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF LA VERNE

Practice address

2061 3Rd St
La Verne, CA 91750-4404

Phone

(909) 596-5991

NPI assigned

Jul 22, 2005

Organization subpart

No

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

Authorized official

Name

Pete Jankowski

Title

Fire Chief

Phone

(909) 596-5991

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": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1740280494",
    "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": "2061 3RD ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917504404",
            "telephone_number": "909-596-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF LA VERNE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "JANKOWSKI",
        "authorized_official_first_name": "PETE",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "909-596-5991"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE01111F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "P00062153",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carole Ishan Chiang, D.P.M.
• Craig Alan Childress, PSY.D.
• Tony Chin, OTR/L
• Kyung Duk Choi, DDS
• Leeann Chu, DDS
• Robin Lorinne Clarkson, MPT
• Dora Jeanette Cobian
• Carolyn Fuller Cockrell, LMFT
• Courtney Collins, DPT
• Simone Collins

• Land Ambulance in La Verne, CA
• Providers in La Verne, 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.