Healthcare Provider Details

I. General information

NPI: 1174604557
Provider Name (Legal Business Name): BIG BEAR CITY COMMUNITY SERVICES DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 WEST BIG BEAR BLVD
BIG BEAR CITY CA
92314
US

IV. Provider business mailing address

PO BOX 558
BIG BEAR CITY CA
92314-0558
US

V. Phone/Fax

Practice location:
  • Phone: 909-584-4024
  • Fax: 909-585-0348
Mailing address:
  • Phone: 909-584-4010
  • Fax: 909-585-0025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL KEVIN MAYER
Title or Position: FINANCE OFFICER
Credential:
Phone: 909-584-4010