Healthcare Provider Details

I. General information

NPI: 1679749501
Provider Name (Legal Business Name): COMMUNITY HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22675 ALESSANDRO BLVD
MORENO VALLEY CA
92553-8551
US

IV. Provider business mailing address

7880 MISSION GROVE PKWY S
RIVERSIDE CA
92508-6000
US

V. Phone/Fax

Practice location:
  • Phone: 951-571-2350
  • Fax: 951-571-2370
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 Code122300000X
TaxonomyDentist
License Number27343
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number46894
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number47987
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT5169TPA
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA99343
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number550000802
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6440
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA50693
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11428
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number10648
License Number StateCA
# 12
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 13
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number436046
License Number StateCA

VIII. Authorized Official

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