Healthcare Provider Details
I. General information
NPI: 1518874866
Provider Name (Legal Business Name): SANCTUARY HEALTH CLINIC - COPTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2345 5TH ST
NORCO CA
92860-1977
US
IV. Provider business mailing address
2345 5TH ST
NORCO CA
92860-1977
US
V. Phone/Fax
- Phone: 951-254-2767
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MIRIAM
MORKOS
Title or Position: CLINICAL COORDINATOR
Credential: PHARMD
Phone: 951-642-5922