Provider Demographics
NPI:1134133473
Name:CITY OF PASADENA
Entity Type:Organization
Organization Name:CITY OF PASADENA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAWKESWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-744-4350
Mailing Address - Street 1:100 N GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109
Mailing Address - Country:US
Mailing Address - Phone:626-744-4293
Mailing Address - Fax:626-744-7132
Practice Address - Street 1:100 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91109
Practice Address - Country:US
Practice Address - Phone:626-744-4293
Practice Address - Fax:626-744-7132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ46426ZMedicaid
CAZZZ46426ZOtherBLUE SHIELD OF CALIFORNIA
CAZZZ46426ZOtherBLUE SHIELD OF CALIFORNIA
CA590086299Medicare ID - Type UnspecifiedRAILROAD MEDICARE