Riverside-San Bernardino County Indian Health, Inc.

LBN: Riverside-San Bernardino County Indian Health, Inc.
Riverside-San Bernardino County Indian Health, Inc. is an health care organization with primary practice located at 11980 Mount Vernon Ave , Grand Terrace CA 92313-5172. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Riverside-San Bernardino County Indian Health, Inc. can be contacted via phone (909) 864-1097, or through Thomsen, William via phone (951) 864-1097.

Contact Information

Primary practice address
11980 Mount Vernon Ave Grand Terrace CA 92313-5172
Phone: (909) 864-1097
Fax: (951) 252-6879
Website:
Map and Directions
Authorized official contact:
Name: Thomsen, William
Phone: (951) 864-1097

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 240000751 California
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 250000055 California

Profile Details

NPI number 1720178478
LBN Legal business name Riverside-San Bernardino County Indian Health, Inc.
DBA Doing business as
Authorized official Thomsen, William
Entity Organization
Organization subpart 1 No
Enumeration date Oct 13th, 2006
Last updated Aug 24th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720178478 NPPES
California MEDICAID FHC03869F
California MEDICAID FHC03854F
California MEDICAID FHC70271F
California Other EAP03854F

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