Healthcare Provider Details

I. General information

NPI: 1306016555
Provider Name (Legal Business Name): COUNTY OF SAN BERNARDINO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 12/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 EAST LUGONIA AVENUE SUITE F
REDLANDS CA
92374-2550
US

IV. Provider business mailing address

351 NORTH MOUNTAIN VIEW AVENUE ROOM 303
SAN BERNARDINO CA
92415-0010
US

V. Phone/Fax

Practice location:
  • Phone: 909-793-6399
  • Fax:
Mailing address:
  • Phone: 909-387-6219
  • Fax: 909-387-6228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. GERTRUDE RAYMUNDO
Title or Position: PUBLIC HEALTH DIRECTOR
Credential:
Phone: 909-387-9146