Provider Demographics
NPI:1699775031
Name:CITY OF SAN CLEMENTE
Entity type:Organization
Organization Name:CITY OF SAN CLEMENTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT ANALYST-FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMELZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-218-9601
Mailing Address - Street 1:PO BOX 269110
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-9110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:910 CALLE NEGOCIO
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-6268
Practice Address - Country:US
Practice Address - Phone:949-361-8315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ70020ZMedicaid
590086456OtherRRB