Provider Demographics
NPI:1013908367
Name:DEL NORTE AMBULANCE, INC.
Entity Type:Organization
Organization Name:DEL NORTE AMBULANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-487-1116
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-0306
Mailing Address - Country:US
Mailing Address - Phone:707-487-1116
Mailing Address - Fax:707-487-3116
Practice Address - Street 1:2600 MOOREHEAD RD
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-7904
Practice Address - Country:US
Practice Address - Phone:707-487-1116
Practice Address - Fax:707-487-3116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR124560Medicaid
CAMTA00613FMedicaid
CAMTE00490FMedicaid
OR232496Medicaid
CAMTE00490FMedicaid