Healthcare Provider Details

I. General information

NPI: 1962520528
Provider Name (Legal Business Name): LUCERNE VALLEY FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33269 OLD WOMAN SPRINGS RD
LUCERNE VALLEY CA
92356
US

IV. Provider business mailing address

157 W 5TH ST
SAN BERNARDINO CA
92415-1012
US

V. Phone/Fax

Practice location:
  • Phone: 760-248-7322
  • 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: PAT DENNEN
Title or Position: FIRE CHIEF
Credential:
Phone: 909-387-6158