1174604557 NPI number — BIG BEAR CITY COMMUNITY SERVICES DISTRICT

Table of content: (NPI 1174604557)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174604557 NPI number — BIG BEAR CITY COMMUNITY SERVICES DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIG BEAR CITY COMMUNITY SERVICES DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174604557
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 558
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIG BEAR CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92314-0558
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-584-4010
Provider Business Mailing Address Fax Number:
909-585-0025

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 WEST BIG BEAR BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIG BEAR CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-584-4024
Provider Business Practice Location Address Fax Number:
909-585-0348
Provider Enumeration Date:
10/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MAYER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
KEVIN
Authorized Official Title or Position:
FINANCE OFFICER
Authorized Official Telephone Number:
909-584-4010

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com