Organization Active NPI

City of Cathedral City

  • Land Ambulance
  • Cathedral City, CA
National Provider Identifier
1831198779
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
CITY OF CATHEDRAL CITY
Practice address
32100 Desert Vista Rd
Cathedral City, CA 92234-4225
Phone
(760) 770-8200
NPI assigned
Jul 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Authorized official

Name
Paul Wilson
Title
Fire Chief
Phone
(760) 770-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

32100 Desert Vista Rd
Cathedral City, CA 92234-4225

Mailing address

PO Box 269110
Sacramento, CA 95826-9110

Other identifiers 2

IdentifierTypeStateIssuer
590005416OtherCARRB
MTE00425FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120301000844 CA Part B Supplier - Ambulance Service Supplier 2062458847 Practice locations: Cathedral City, CA

National Provider Directory

National Provider Directory

Locations

68700 Avenida Lalo Guerrero
Cathedral City, CA 92234

27610 Landau Blvd
Cathedral City, CA 92234
Phone (760) 770-8200

36913 Date Palm Dr
Cathedral City, CA 92234
Phone (760) 770-8200

32100 Desert Vista Rd
Cathedral Cty, CA 92234
Phone (619) 770-0340

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1831198779",
    "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": "32100 DESERT VISTA RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922344225",
            "telephone_number": "760-770-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF CATHEDRAL CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "760-770-8200"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "590005416",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE00425F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cathedral City, CA

Sources for this page

  • 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.