MEDICARE: BIG BEAR CITY COMMUNITY SERVICES 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

General Provider Information

NPI Number	:	1174604557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIG BEAR CITY COMMUNITY SERVICES DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 558
Second Line	:
City	:	BIG BEAR CITY
State	:	CA
Zip	:	92314-0558
Country	:	US
Telephone Number	:	909-584-4010
Fax Number	:	909-585-0025

Provider Business Practice Location Address
First Line	:	301 WEST BIG BEAR BLVD
Second Line	:
City	:	BIG BEAR CITY
State	:	CA
Zip	:	92314
Country	:	US
Telephone Number	:	909-584-4024
Fax Number	:	909-585-0348

Authorized Official
Title or Position	:	FINANCE OFFICER
Name	:	MR. MICHAEL KEVIN MAYER
Credential	:
Telephone Number	:	909-584-4010

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/22/2020

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Directions to “BIG BEAR CITY COMMUNITY SERVICES DISTRICT ” Practice Location

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