Provider Demographics
NPI:1912907668
Name:CITY OF COALINGA
Entity type:Organization
Organization Name:CITY OF COALINGA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-935-1652
Mailing Address - Street 1:PO BOX 45159
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94145-0159
Mailing Address - Country:US
Mailing Address - Phone:916-381-6552
Mailing Address - Fax:916-471-5107
Practice Address - Street 1:300 W ELM AVE
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210
Practice Address - Country:US
Practice Address - Phone:559-935-1652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ35677ZMedicaid
CA756590647OtherRRB
CAZZZ35677ZMedicaid