RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH INC. NPI 1386837227

NPI Information

NPI: 1386837227
Provider Name: RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.

Doing Business As: SOBOBA INDIAN HEALTH CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
607 DONNA WAY
SAN JACINTO, CA
ZIP 92583
Phone: (951) 654-0803
Get Directions

RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. is a federally qualified health center (fqhc) clinic center in San Jacinto, CA. RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. NPI is 1386837227. The provider is registered as an organization entity type.
The provider Is Doing Business As Soboba Indian Health Clinic.

The provider's business location address is:

607 DONNA WAY
SAN JACINTO, CA
ZIP 92583-517
Phone: (951) 654-0803
Fax: (951) 654-9387

The provider's authorized official is William Thomsen .
The authorized official title is Ceo and has the following contact phone number (909) 864-1097.

The CLIA number assigned to this NPI record is 05D0574327 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 8/23/2007 and was last updated on 8/25/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BCP70271F	MEDICAID	CALIFORNIA
2	FHC70271F	MEDICAID	CALIFORNIA

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: 11/14/2023

NPI Synchronization or Removal

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