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General NPI Number Information
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NPI Number | 1053469379
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH SYSTEMS
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1970 UNIVERSITY AVE
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City | RIVERSIDE
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State | CA
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Zip | 92507-5202
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Country | US
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Telephone | 951-276-0668
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Fax | 951-328-9578
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Provider Business Mailing Address
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Address Line | 1970 UNIVERSITY AVE
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City | RIVERSIDE
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State | CA
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Zip | 92507-5202
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Country | US
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Telephone | 951-276-0668
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Fax | 951-328-9578
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Authorized Official
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Title or Position | CEO
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Name | BOBBY V VASCOVICH
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Credential | MR
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Telephone | 951-588-0861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 47180
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License Number State | CA
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