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Organization

PENINSULA FIRE DISTRICT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. HOLLY C COONS (ADMINISTRATIVE SECRETARY)
(530) 259-2306
Entity
Organization

Contact information

Practice address
801 GOLF CLUB RD, LAKE ALMANOR, CA 96137
(530) 259-2306
(530) 259-3707
Mailing address
801 GOLF CLUB RD, LAKE ALMANOR, CA 96137-9524
(530) 259-2306
(530) 259-3707

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
CA
3416S0300X
Water Ambulance
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
APENI977H
BLUE CROSS
CA
05
MTE00760F
CA
01
ZZZ65564Z
BLUE SHIELD
CA
Enumeration date
01/22/2007
Last updated
07/21/2022
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