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General NPI Number Information
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NPI Number | 1558501890
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Entity Type | Organization
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Legal Business Name | NORCAL AMBULANCE, LLC
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Dates
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Enumeration Date | 02/26/2009
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Last Update Date | 02/26/2009
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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 | 707-665-4284
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Fax | 707-585-6341
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Provider Business Mailing Address
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Address Line | PO BOX 3108
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City | ROHNERT PARK
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State | CA
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Zip | 94927-3108
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FINANCE DIRECTOR
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Name | HEIDI RUNYON
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Credential |
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Telephone | 707-665-4284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 200819710203
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License Number State | CA
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