MEDICARE: CITY OF ALHAMBRA

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
2	756590401	OTHER	CA	RRB

General Provider Information

NPI Number	:	1790780112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF ALHAMBRA

Provider Business Mailing Address
First Line	:	DEPT LA 23211
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91185-0974
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N 1ST ST
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91801-2454
Country	:	US
Telephone Number	:	626-308-4855
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	THOMAS PHELPS
Credential	:
Telephone Number	:	626-570-5191

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	12/10/2019

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Directions to “CITY OF ALHAMBRA ” Practice Location

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