Healthcare Provider Details

I. General information

NPI: 1053257568
Provider Name (Legal Business Name): SAN ANTONIO REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11000 EUCALYPTUS ST STE 155
RANCHO CUCAMONGA CA
91730-7663
US

IV. Provider business mailing address

11000 EUCALYPTUS ST STE 155
RANCHO CUCAMONGA CA
91730-7663
US

V. Phone/Fax

Practice location:
  • Phone: 909-579-6870
  • Fax:
Mailing address:
  • Phone: 909-579-6870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PETER APRATO
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 909-694-1098