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COMMUNITY HOSPITAL OF SAN BERNARDINO NPI 1851395685


NPI Information

NPI: 1851395685
Provider Name: COMMUNITY HOSPITAL OF SAN BERNARDINO

Doing Business As: COMMUNITY CONVALESCENT CENTER OF SAN BERNARDINO

Classification: Skilled Nursing Facility - 3140N1450X
Entity Type: Organization

Specialization: Nursing Care, Pediatric

CLIA Number: 05D0575263

Address:
1676 MEDICAL CENTER DR
SAN BERNARDINO, CA
ZIP 92411
Phone: (909) 887-6481
Get Directions

COMMUNITY HOSPITAL OF SAN BERNARDINO is a nursing care and pediatric skilled nursing facility in San Bernardino, CA. The provider is a nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. COMMUNITY HOSPITAL OF SAN BERNARDINO NPI is 1851395685. The provider is registered as an organization entity type.
The provider Is Doing Business As Community Convalescent Center Of San Bernardino.

The provider's business location address is:

1676 MEDICAL CENTER DR
SAN BERNARDINO, CA
ZIP 92411-213
Phone: (909) 887-6481
Fax: (909) 887-3858

The provider's authorized official is Ed Sorenson .
The authorized official title is V.p. Fianance, Cfo and has the following contact phone number (909) 887-6333.

The CLIA number assigned to this NPI record is 05D0575263 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/9/2005 and was last updated on 9/23/2013.


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
13140N1450XSkilled Nursing FacilityNursing Care, Pediatric240000185CALIFORNIAYes

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
1LTC40010FMEDICAIDCALIFORNIA
2ZZT06107IMEDICAIDCALIFORNIA
3LTP40010FMEDICAIDCALIFORNIA
4056107MEDICARE OSCAR/CERTIFICATIONCALIFORNIA

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

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