| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 06/23/2022 |
| Last Update Date | 06/23/2022 |
| Medicare PECOS PAC ID | 4789867805 |
|---|---|
| Medicare Enrollment ID | O20230217001561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679204325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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