Active NPI
Lucerne Valley Fire District
- Land Ambulance
- Lucerne Valley, CA
National Provider Identifier
1962520528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- LUCERNE VALLEY FIRE DISTRICT
- Practice address
- 33269 Old Woman Springs Rd
Lucerne Valley, CA 92356 - Phone
- (760) 248-7322
- NPI assigned
- Mar 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pat Dennen
- Title
- Fire Chief
- Phone
- (909) 387-6158
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Primary |
Addresses
Primary practice location
33269 Old Woman Springs Rd
Lucerne Valley, CA 92356
Mailing address
157 W 5TH St
San Bernardino, CA 92415-1012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MTE00128F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050427001193 | CA | Part B Supplier - Ambulance Service Supplier | 3870499130 |
4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: San Bernardino, CA; Yucca Valley, CA; Wrightwood, CA; Twin Peaks, CA; Trona, CA; Phelan, CA; Needles, CA; Lucerne Valley, CA… |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
157 W 5th St
San Bernardino, CA 92415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1193011200000",
"number": "1962520528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "157 W 5TH ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924151012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33269 OLD WOMAN SPRINGS RD",
"city": "LUCERNE VALLEY",
"state": "CA",
"postal_code": "92356",
"telephone_number": "760-248-7322"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LUCERNE VALLEY FIRE DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-26",
"last_updated": "2007-10-22",
"status": "A",
"authorized_official_last_name": "DENNEN",
"authorized_official_first_name": "PAT",
"authorized_official_title_or_position": "FIRE CHIEF",
"authorized_official_telephone_number": "909-387-6158"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MTE00128F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lucerne Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.