Organization
LAKESHORE FIRE PROT DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SAPETA (FIRE CHIEF)
(707) 994-2170
Entity
Organization
Contact information
Practice address
14815 OLYMPIC DR, CLEARLAKE, CA 95422-9522
(707) 994-2170
Mailing address
14815 OLYMPIC DRIVE, CLEARLAKE, CA 95422
(707) 994-2170
(707) 994-4861
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
560013519
RRB
—
05
—
MTN00005F
—
CA
Enumeration date
07/28/2005
Last updated
05/04/2016
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