Organization
CSA 56 WRIGHTWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAT DENNEN (FIRE CHIEF)
(909) 387-6158
Entity
Organization
Contact information
Practice address
5980 ELM ST, WRIGHTWOOD, CA 92397
(760) 249-3206
Mailing address
157 W 5TH ST FL 2, SAN BERNARDINO, CA 92415-0440
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ35067Z
—
CA
Enumeration date
03/26/2007
Last updated
10/18/2007
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