=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649865536
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITY OF NATIONAL CITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2021
-----------------------------------------------------
Last Update Date | 03/03/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 343 E 16TH ST
-----------------------------------------------------
City | NATIONAL CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91950-4507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-336-4566
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1243 NATIONAL CITY BLVD
-----------------------------------------------------
City | NATIONAL CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91950-4301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-336-4550
-----------------------------------------------------
Fax | 619-336-4562
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF OF EMERGENCY SERVICES
-----------------------------------------------------
Name | FRANK PARRA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 619-336-4551
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------