Riverside-san Bernardino County Indian Health, Inc | |
53000 Cahuilla Road Anza CA 92539-9231 | |
(909) 864-1097 | |
(951) 225-6879 |
Full Name | Riverside-san Bernardino County Indian Health, Inc |
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Speciality | Clinic/Center |
Location | 53000 Cahuilla Road, Anza, California |
Authorized Official Name and Position | Vuliet Danial (CONTRACTS/CREDENTIALING) |
Authorized Official Contact | 9098641097 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Riverside-san Bernardino County Indian Health, Inc 11980 Mount Vernon Ave Grand Terrace CA 92313-5172 Ph: (909) 864-1097 | Riverside-san Bernardino County Indian Health, Inc 53000 Cahuilla Road Anza CA 92539-9231 Ph: (909) 864-1097 |
NPI Number | 1679204325 |
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Provider Enumeration Date | 06/23/2022 |
Last Update Date | 06/23/2022 |
Medicare PECOS PAC ID | 4789867805 |
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Medicare Enrollment ID | O20230217001561 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679204325 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Anza Community Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 56480 Highway 371, Anza, CA 92539 Phone: 951-694-8549 Fax: 951-694-0249 | |