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General NPI Number Information
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NPI Number | 1740289651
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Entity Type | Organization
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Legal Business Name | BODEGA BAY FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 10/17/2007
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Provider Practice Location Address
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Address Line | 510 S HIGHWAY 1
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City | BODEGA BAY
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State | CA
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Zip | 94923-9772
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Country | US
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Telephone | 707-875-3700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 269110
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City | SACRAMENTO
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State | CA
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Zip | 95826-9110
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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 | FIRE CHIEF
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Name | SEAN GRINNELL
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Credential |
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Telephone | 707-875-3700
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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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