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General NPI Number Information
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NPI Number | 1912064999
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Entity Type | Organization
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Legal Business Name | LAKESIDE FIRE PROTECTION
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 12365 PARKSIDE ST
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City | LAKESIDE
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State | CA
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Zip | 92040-3006
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Country | US
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Telephone | 619-390-2369
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 510
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City | ALAMEDA
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State | CA
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Zip | 94501-9610
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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 | DEPUTY CHIEF
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Name | ANDY PARR
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Credential |
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Telephone | 619-390-2369
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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 |
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License Number State |
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