Provider Demographics
NPI:1063858611
Name:CITY OF ONTARIO
Entity Type:Organization
Organization Name:CITY OF ONTARIO
Other - Org Name:CITY OF ONTARIO - FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:GAYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-395-2002
Mailing Address - Street 1:425 E B ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-4107
Mailing Address - Country:US
Mailing Address - Phone:909-395-2002
Mailing Address - Fax:909-395-2556
Practice Address - Street 1:425 E B ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4107
Practice Address - Country:US
Practice Address - Phone:909-395-2002
Practice Address - Fax:909-395-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-21
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty