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General NPI Number Information
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NPI Number | 1154886166
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Entity Type | Organization
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Legal Business Name | LIFEWEST NORTHERN CALIFORNIA
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 720 PORTAL ST
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City | COTATI
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State | CA
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Zip | 94931-3060
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Country | US
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Telephone | 707-755-5060
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Fax | 707-755-5067
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Provider Business Mailing Address
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Address Line | PO BOX 2930
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City | SANTA ROSA
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State | CA
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Zip | 95405-0930
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Country | US
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Telephone | 800-811-4045
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | SEAN SULLIVAN
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Credential |
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Telephone | 707-766-2404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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