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COMMUNITY HOSPITAL OF SAN BERNARDINO NPI 1235290818


NPI Information

NPI: 1235290818
Provider Name: COMMUNITY HOSPITAL OF SAN BERNARDINO
Classification: General Acute Care Hospital - 282N00000X
Entity Type: Organization

CLIA Number: 05D0575254

Address:
1805 MEDICAL CENTER DR
SAN BERNARDINO, CA
ZIP 92411
Phone: (909) 887-6333
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COMMUNITY HOSPITAL OF SAN BERNARDINO is a general acute care hospital in San Bernardino, CA. The provider is an acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. COMMUNITY HOSPITAL OF SAN BERNARDINO NPI is 1235290818. The provider is registered as an organization entity type.

The provider's business location address is:

1805 MEDICAL CENTER DR
SAN BERNARDINO, CA
ZIP 92411-217
Phone: (909) 887-6333
Fax: (909) 806-1017

The provider's authorized official is Darryl Vandenbosch .
The authorized official title is Cfo and has the following contact phone number (909) 881-7196.

The CLIA number assigned to this NPI record is 05D0575254 - ancillary testing site in health care center with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 12/13/2006 and was last updated on 1/26/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1273R00000XPsychiatric Unit240000198CALIFORNIANo
2314000000XSkilled Nursing Facility240000198CALIFORNIANo
33336I0012XPharmacyInstitutional PharmacyHSP37939CALIFORNIANo
4282N00000XGeneral Acute Care Hospital240000198CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1LTC70044FMEDICAIDCALIFORNIA
2050089MEDICARE OSCAR/CERTIFICATIONCALIFORNIA
3555522MEDICARE OSCAR/CERTIFICATIONCALIFORNIA
4HSM30089FMEDICAIDCALIFORNIA
5ZZZA3608ZOTHERCALIFORNIABLUE SHIELD
6=========OTHERCALIFORNIATAX ID
75615375OTHERNCPDP
8PHB379390MEDICAIDCALIFORNIA
9HSC30089FMEDICAIDCALIFORNIA
10ZZT40089FMEDICAIDCALIFORNIA
1105S089MEDICARE OSCAR/CERTIFICATIONCALIFORNIA
12=========924110002OTHERCALIFORNIAWPSTRICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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