Inland Empire Community Health Center | |
18601 Valley Blvd Bloomington CA 92316-1831 | |
(909) 877-1818 | |
(909) 746-0400 |
Full Name | Inland Empire Community Health Center |
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Speciality | Clinic/Center |
Location | 18601 Valley Blvd, Bloomington, California |
Authorized Official Name and Position | Bobby Vascovich (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 9098771818 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Inland Empire Community Health Center 18601 Valley Blvd Bloomington CA 92316-1831 Ph: (909) 877-1818 | Inland Empire Community Health Center 18601 Valley Blvd Bloomington CA 92316-1831 Ph: (909) 877-1818 |
NPI Number | 1952308009 |
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Provider Enumeration Date | 07/05/2005 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 7012824717 |
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Medicare Enrollment ID | O20051117000822 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952308009 | NPI | - | NPPES |
G98054-01 | Other | CA | DELTA DENTAL |
G98054-03 | Other | CA | DELTA DENTAL |
HAP70865F | Other | CA | FAMILY PACT |
HAP70324F | Other | CA | FAMILY PACT |
FHC70275G | Medicaid | CA | |
FHC70324F | Medicaid | CA | |
FHC71040F | Medicaid | CA | |
G98054-02 | Other | CA | DELTA DENTAL |
HAP70275G | Other | CA | FAMILY PACT |
FHC70865F | Medicaid | CA |
Provider Name | Chinye Ogbuchiekwe |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316162381 PECOS PAC ID: 0749295608 Enrollment ID: I20060214000225 |
Provider Name | Tim T Le |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1366480188 PECOS PAC ID: 1355348772 Enrollment ID: I20061027000292 |
Provider Name | Melissa A Staricka |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134270713 PECOS PAC ID: 6608939772 Enrollment ID: I20090115000475 |
Provider Name | Lawrence Franklin Pearson |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1538234190 PECOS PAC ID: 7810051596 Enrollment ID: I20090123000449 |
Provider Name | Wayne T Larsen |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1972685089 PECOS PAC ID: 2961545710 Enrollment ID: I20100202000902 |
Provider Name | Sai H Wong |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1750583928 PECOS PAC ID: 8123200284 Enrollment ID: I20110310000435 |
Provider Name | Murtaza Merali |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1972944189 PECOS PAC ID: 9133353089 Enrollment ID: I20131008000401 |
Provider Name | Suzan J Shakhshir |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275875759 PECOS PAC ID: 6608009667 Enrollment ID: I20140429001215 |
Provider Name | Meenu Sood |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1841588928 PECOS PAC ID: 1456572700 Enrollment ID: I20141029002817 |
Provider Name | Sheimeka D Vaughan Magee |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912293556 PECOS PAC ID: 1254653066 Enrollment ID: I20141205001842 |
Provider Name | Janna E Larson |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1821227554 PECOS PAC ID: 3971828898 Enrollment ID: I20150217000002 |
Provider Name | George Y Soliman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730193368 PECOS PAC ID: 9830179803 Enrollment ID: I20150619001931 |
Provider Name | Calvin E Lambert Hall |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427483254 PECOS PAC ID: 1456667138 Enrollment ID: I20150825005615 |
Provider Name | Ryan O Macavinta |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518311190 PECOS PAC ID: 9335439793 Enrollment ID: I20160526001692 |
Provider Name | Sarah A Papalia |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1336572676 PECOS PAC ID: 1759515307 Enrollment ID: I20161116000481 |
Provider Name | Laura L Gilroy |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1437427978 PECOS PAC ID: 6800179664 Enrollment ID: I20170202000593 |
Provider Name | Manmit K Anand |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124563366 PECOS PAC ID: 1850674326 Enrollment ID: I20170207001330 |
Provider Name | Reem Ali Abu Libdeh |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1972985158 PECOS PAC ID: 6507131778 Enrollment ID: I20171013002980 |
Provider Name | Diana A Plucker |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568877629 PECOS PAC ID: 9133345119 Enrollment ID: I20171030001698 |
Provider Name | Renee S Miles |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1053763623 PECOS PAC ID: 0547528564 Enrollment ID: I20171221001275 |
Provider Name | Manja Perilla |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568981413 PECOS PAC ID: 9032477971 Enrollment ID: I20171221002476 |
Provider Name | Sandra W Edpao |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689190431 PECOS PAC ID: 7416215066 Enrollment ID: I20180103001694 |
Provider Name | Sanjeev Puri |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730420399 PECOS PAC ID: 0547570871 Enrollment ID: I20180307001366 |
Provider Name | Dimas Giovanni Calvachi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386143881 PECOS PAC ID: 3375804305 Enrollment ID: I20180307001660 |
Provider Name | Munira M Rahman |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1639597578 PECOS PAC ID: 0143447391 Enrollment ID: I20180827000185 |
Provider Name | Ganiat Gbadebo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770002990 PECOS PAC ID: 7416209127 Enrollment ID: I20181008003049 |
Provider Name | Ian William Kirby |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639633084 PECOS PAC ID: 1052652617 Enrollment ID: I20190408002390 |
Provider Name | Louis Lennart Qui |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992280531 PECOS PAC ID: 2769716257 Enrollment ID: I20190703001666 |
Provider Name | Raymond G Rojas |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1487933602 PECOS PAC ID: 5799110664 Enrollment ID: I20200123000303 |
Bloomington Community Health Center - Building 2 Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18651 Valley Blvd Unit A, Bloomington, CA 92316 Phone: 951-571-2300 |