Provider Demographics
NPI:1578677696
Name:CITY OF SAN DIEGO
Entity Type:Organization
Organization Name:CITY OF SAN DIEGO
Other - Org Name:CITY OF SAN DIEGO EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ISSABELLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-279-3341
Mailing Address - Street 1:404 S. MIER ST.
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:TX
Mailing Address - Zip Code:78384-4320
Mailing Address - Country:US
Mailing Address - Phone:631-279-3341
Mailing Address - Fax:361-279-3401
Practice Address - Street 1:100 S DR EE DUNLAP HIGHWAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:TX
Practice Address - Zip Code:78384-4320
Practice Address - Country:US
Practice Address - Phone:361-279-3341
Practice Address - Fax:361-279-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0660073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000510001Medicaid
TX000510001Medicaid