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250 S G St San Bernardino CA 92410-3320 | |
(909) 382-7100 | |
(909) 382-7100 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 250 S G St, San Bernardino, California |
Authorized Official Name and Position | Tasha Amick (DIRECTOR OF BILLING) |
Authorized Official Contact | 9093827180 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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250 S G St San Bernardino CA 92410-3320 Ph: (909) 382-7180 | 250 S G St San Bernardino CA 92410-3320 Ph: (909) 382-7100 |
NPI Number | 1437784410 |
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Provider Enumeration Date | 03/10/2020 |
Last Update Date | 09/01/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437784410 | NPI | - | NPPES |
EAP70708F | Other | CA | EAPC |
CMM70708F | Medicaid | CA | |
ENVOY3000 | Other | CA | ENVOY SITE ID |
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