MEDICARE: CITY OF PETALUMA AMBULANCE SERVICE

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
1	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	756590183	OTHER		RRB

General Provider Information

NPI Number	:	1720087661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF PETALUMA AMBULANCE SERVICE

Provider Business Mailing Address
First Line	:	11 ENGLISH ST STE 1
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94952-2610
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	198 D ST
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94952-3028
Country	:	US
Telephone Number	:	707-778-4364
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	CHRIS ALBERTSON
Credential	:
Telephone Number	:	707-778-4364

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	06/01/2011

Similar Medicare Providers

1366032682 — DANIELLE RESTIEAUX-LOUIS MSW, ASW
Practice Location Address:

670 D ST
PETALUMA, CA
94952-3023

Practice Phone: 707-756-6271
Practice Fax:

1124371075 — TIFFANY WESTERHOLD
Practice Location Address:

405 E D ST # 100B
PETALUMA, CA
94952-3177

Practice Phone: 707-583-9048
Practice Fax:

1144170556 — ANGELICA POLISERI
Practice Location Address:

200 DOUGLAS ST
PETALUMA, CA
94952-2567

Practice Phone: 707-778-4813
Practice Fax:

1326999764 — STEPHANIE MOYADO
Practice Location Address:

1500 PETALUMA BLVD S STE A
PETALUMA, CA
94952-5546

Practice Phone: 707-765-8488
Practice Fax:

1164373130 — MARC ANTHONY HOFFMAN
Practice Location Address:

404 KELLER ST
PETALUMA, CA
94952-2860

Practice Phone: 707-623-2849
Practice Fax:

1093718454 — MR. ROBERT O BUTLER LCSW
Practice Location Address:

40 4TH ST STE 224
PETALUMA, CA
94952-3040

Practice Phone: 707-241-3003
Practice Fax:

Directions to “CITY OF PETALUMA AMBULANCE SERVICE ” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.