Provider Demographics
NPI:1730227737
Name:CREST FOREST FIRE PROTECTION DISTRICT
Entity type:Organization
Organization Name:CREST FOREST FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-338-3311
Mailing Address - Street 1:PO BOX 3220
Mailing Address - Street 2:
Mailing Address - City:CRESTLINE
Mailing Address - State:CA
Mailing Address - Zip Code:92325-3220
Mailing Address - Country:US
Mailing Address - Phone:909-338-3311
Mailing Address - Fax:909-338-3217
Practice Address - Street 1:23407 CREST FOREST DR
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:CA
Practice Address - Zip Code:92325
Practice Address - Country:US
Practice Address - Phone:909-338-3311
Practice Address - Fax:909-338-3217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE00616FMedicaid
CAZZZ35182ZMedicare ID - Type Unspecified