Healthcare Provider Details

I. General information

NPI: 1487706347
Provider Name (Legal Business Name): COMMUNITY HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18601 VALLEY BLVD
BLOOMINGTON CA
92316-1831
US

IV. Provider business mailing address

7880 MISSION GROVE PKWY S
RIVERSIDE CA
92508-6000
US

V. Phone/Fax

Practice location:
  • Phone: 909-546-7520
  • Fax: 909-877-5468
Mailing address:
  • Phone: 951-571-2300
  • Fax: 951-200-3063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number40093
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number46894
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number40996
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number47987
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT12626TPA
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number387455
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA98737
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA110976
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA87726
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number506572
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA1157855
License Number StateCA
# 12
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number240000086
License Number StateCA

VIII. Authorized Official

Name: LORI NANETTE HOLEMAN
Title or Position: CEO
Credential:
Phone: 951-571-2300