Organization
CITY OF PASADENA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW E. HAWKESWORTH (DIRECTOR OF FINANCE)
(626) 744-4350
Entity
Organization
Contact information
Practice address
100 N GARFIELD AVE, PASADENA, CA 91109
(626) 744-4293
(626) 744-7132
Mailing address
100 N GARFIELD AVE, PASADENA, CA 91109
(626) 744-4293
(626) 744-7132
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ46426Z
BLUE SHIELD OF CALIFORNIA
CA
05
—
ZZZ46426Z
—
CA
Enumeration date
07/29/2006
Last updated
12/17/2019
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