Provider Demographics
NPI:1790826402
Name:CITY OF BUENA PARK
Entity Type:Organization
Organization Name:CITY OF BUENA PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENCY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VARTANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-288-3800
Mailing Address - Street 1:6650 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2905
Mailing Address - Country:US
Mailing Address - Phone:714-288-3800
Mailing Address - Fax:714-288-3891
Practice Address - Street 1:6650 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2905
Practice Address - Country:US
Practice Address - Phone:714-288-3800
Practice Address - Fax:714-288-3891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty