MEDICARE: DEL NORTE AMBULANCE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013908367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEL NORTE AMBULANCE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 306
Second Line	:
City	:	CRESCENT CITY
State	:	CA
Zip	:	95531-0306
Country	:	US
Telephone Number	:	707-487-1116
Fax Number	:	707-487-3116

Provider Business Practice Location Address
First Line	:	2600 MOOREHEAD RD
Second Line	:
City	:	CRESCENT CITY
State	:	CA
Zip	:	95531-7904
Country	:	US
Telephone Number	:	707-487-1116
Fax Number	:	707-487-3116

Authorized Official
Title or Position	:	CEO
Name	:	MR. RONALD L SANDLER
Credential	:
Telephone Number	:	707-487-1116

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	10/30/2008

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Directions to “DEL NORTE AMBULANCE, INC. ” Practice Location

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