Healthcare Provider Details

I. General information

NPI: 1275023491
Provider Name (Legal Business Name): BRIDGE HOME HEALTH SERVICES INLAND EMPIRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 INLAND EMPIRE BLVD STE 120
ONTARIO CA
91764-4802
US

IV. Provider business mailing address

3636 NOBEL DR STE 450
SAN DIEGO CA
92122-1062
US

V. Phone/Fax

Practice location:
  • Phone: 858-251-4242
  • Fax:
Mailing address:
  • Phone: 858-251-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JEFF MONGONIA
Title or Position: CEO
Credential:
Phone: 858-251-4242