| Sac San Bernardino Campus | |
|
250 South G Street San Bernardino CA 92410 | |
| (909) 382-7100 | |
| Not Available |
| Full Name | Sac San Bernardino Campus |
|---|---|
| Speciality | Clinic/Center |
| Location | 250 South G Street, San Bernardino, California |
| Authorized Official Name and Position | Tasha Amick (DIR OF BILLING) |
| Authorized Official Contact | 9093827180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sac San Bernardino Campus 1454 E 2nd St San Bernardino CA 92408-0118 Ph: (909) 382-7180 | Sac San Bernardino Campus 250 South G Street San Bernardino CA 92410 Ph: (909) 382-7100 |
| NPI Number | 1801270137 |
|---|---|
| Provider Enumeration Date | 07/16/2015 |
| Last Update Date | 09/01/2022 |
| Medicare PECOS PAC ID | 4385533579 |
|---|---|
| Medicare Enrollment ID | O20161101001246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801270137 | NPI | - | NPPES |
| EAP70708F | Other | CA | EAPC |
| CMM70708F | Medicaid | CA | |
| ENVOY3000 | Other | CA | ENVOY SITE ID |
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