Provider Demographics
NPI:1144210147
Name:JULIAN CUYAMACA FIRE PROTECTION
Entity Type:Organization
Organization Name:JULIAN CUYAMACA FIRE PROTECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-439-6581
Mailing Address - Street 1:5050 AVENIDA ENCINAS
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-4383
Mailing Address - Country:US
Mailing Address - Phone:760-439-6581
Mailing Address - Fax:760-268-0924
Practice Address - Street 1:2645 FARMERS RD
Practice Address - Street 2:
Practice Address - City:JULIAN
Practice Address - State:CA
Practice Address - Zip Code:92036
Practice Address - Country:US
Practice Address - Phone:760-439-6581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE00984FMedicaid
CAMTE00984FMedicaid