Healthcare Provider Details

I. General information

NPI: 1114923810
Provider Name (Legal Business Name): CITY OF MONTEREY PARK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W NEWMARK AVE
MONTEREY PARK CA
91754-2818
US

IV. Provider business mailing address

320 W NEWMARK AVE
MONTEREY PARK CA
91754-2818
US

V. Phone/Fax

Practice location:
  • Phone: 626-307-1423
  • 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: SCOTT HABERLE
Title or Position: FIRE CHIEF
Credential:
Phone: 626-307-1262