MEDICARE: SAN RAMON VALLEY FIRE PROTECTION DISTRICT

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	3416L0300X	Land Ambulance

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

General Provider Information

NPI Number	:	1083614374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN RAMON VALLEY FIRE PROTECTION DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 269110
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95826-9110
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 BOLLINGER CANYON RD
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1756
Country	:	US
Telephone Number	:	925-838-6600
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	CRAIG BOWEN
Credential	:
Telephone Number	:	925-838-6601

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	10/18/2007

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