Healthcare Provider Details

I. General information

NPI: 1780761981
Provider Name (Legal Business Name): SAN BERNARDINO COUNTY PUBLIC HEALTH DEPT.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15922 WILLOW ST SIEGRIST MTU
HESPERIA CA
92345-2848
US

IV. Provider business mailing address

451 E VANDERBILT WAY
SAN BERNARDINO CA
92408-3641
US

V. Phone/Fax

Practice location:
  • Phone: 760-244-7999
  • Fax: 760-244-4975
Mailing address:
  • Phone: 909-387-6218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MAXWELL OHIKHUARE
Title or Position: PUBLIC HEALTH OFFICER
Credential: M.D.
Phone: 909-387-6219