Healthcare Provider Details

I. General information

NPI: 1265437701
Provider Name (Legal Business Name): CITY OF CALEXICO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 HEBER AVE
CALEXICO CA
92231-2840
US

IV. Provider business mailing address

608 HEBER AVE
CALEXICO CA
92231-2840
US

V. Phone/Fax

Practice location:
  • Phone: 760-768-2130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PETER F MERCADO
Title or Position: FIRE CHIEF
Credential:
Phone: 760-768-2130