St. Johns Community Health | |
1500 N Waterman Ave San Bernardino CA 92404-5111 | |
(323) 541-1600 | |
(323) 541-1661 |
Full Name | St. Johns Community Health |
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Speciality | Clinic/Center |
Location | 1500 N Waterman Ave, San Bernardino, California |
Authorized Official Name and Position | Maria Socorro Genie (EXECUTIVE PROJECT DIRECTOR) |
Authorized Official Contact | 3235411600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St. Johns Community Health 808 W 58th St Los Angeles CA 90037-3632 Ph: (323) 541-1600 | St. Johns Community Health 1500 N Waterman Ave San Bernardino CA 92404-5111 Ph: (323) 541-1600 |
NPI Number | 1780376947 |
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Provider Enumeration Date | 05/24/2023 |
Last Update Date | 04/30/2024 |
Medicare PECOS PAC ID | 2961482690 |
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Medicare Enrollment ID | O20240404000104 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780376947 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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