Organization
COAST LIFE SUPPORT DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RICE (DISTRICT FISCAL OFFICER)
(707) 884-1829
Entity
Organization
Contact information
Practice address
38901 OCEAN DRIVE, GUALALA, CA 95445-8001
(707) 884-1829
(707) 884-4663
Mailing address
PO BOX 269110, SACRAMENTO, CA 95826-9110
(916) 669-4607
(916) 471-5107
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Enumeration date
09/13/2006
Last updated
06/09/2015
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