Organization
SOUTH LAKE COUNTY FIRE PROTECTION DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG BERTELLI (FIRE CHIEF)
(707) 279-2125
Entity
Organization
Contact information
Practice address
21095 HIGHWAY 175, MIDDLETOWN, CA 95461-9527
(707) 987-3089
Mailing address
PO BOX 269110, SACRAMENTO, CA 95826-9110
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590004954
RRB
—
05
—
ZZZ83591Z
—
CA
Enumeration date
07/26/2005
Last updated
12/17/2019
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