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NPI Code Detail

MEDICARE: COUNTY SERVICE AREA NO 17

MEDICARE: COUNTY SERVICE AREA NO 17
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13416L0300XLand Ambulance

General Provider Information

NPI Number : 1497024731
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTY SERVICE AREA NO 17
Provider Business Mailing Address
First Line : 5560 OVERLAND AVENUE, SUITE 400
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1204
Country : US
Telephone Number : 858-245-4231
Fax Number :
Provider Business Practice Location Address
First Line : 5560 OVERLAND AVE STE 400
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1204
Country : US
Telephone Number : 858-245-4231
Fax Number :
Authorized Official
Title or Position : EMS ADMINISTRATOR
Name : ANDREW DORMANN PARR
Credential :
Telephone Number : 858-245-4231
Provider Enumeration Date : 12/15/2011
Last Update Date : 03/22/2023

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Directions to “COUNTY SERVICE AREA NO 17 ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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