Provider Demographics
NPI:1114792652
Name:CITY OF COSTA MESA
Entity Type:Organization
Organization Name:CITY OF COSTA MESA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-754-5328
Mailing Address - Street 1:PO BOX 1200
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92628-1200
Mailing Address - Country:US
Mailing Address - Phone:714-754-5000
Mailing Address - Fax:
Practice Address - Street 1:3175 AIRWAY AVE
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4655
Practice Address - Country:US
Practice Address - Phone:714-754-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty