Provider Demographics
NPI:1487756342
Name:CITY OF POWAY CALIFORNIA
Entity type:Organization
Organization Name:CITY OF POWAY CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SAFTEY SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-668-4402
Mailing Address - Street 1:PO BOX 789
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92074-0789
Mailing Address - Country:US
Mailing Address - Phone:858-668-4402
Mailing Address - Fax:858-668-1209
Practice Address - Street 1:13325 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-5755
Practice Address - Country:US
Practice Address - Phone:858-668-4402
Practice Address - Fax:858-668-1209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ73586ZMedicaid
CAZA398Medicare ID - Type UnspecifiedPROVIDER NUMBER