Healthcare Provider Details

I. General information

NPI: 1851523179
Provider Name (Legal Business Name): CITY OF GARDEN GROVE FIRE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 08/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 ACACIA PKWY
GARDEN GROVE CA
92840-5310
US

IV. Provider business mailing address

1517 W BRADEN CT
ORANGE CA
92868-1125
US

V. Phone/Fax

Practice location:
  • Phone: 714-741-5600
  • Fax:
Mailing address:
  • Phone: 714-288-3800
  • Fax: 714-289-7902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State

VIII. Authorized Official

Name: MS. LAURA L VARTANIAN
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 714-288-3800