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General NPI Number Information
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NPI Number | 1174570725
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Entity Type | Organization
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Legal Business Name | REDLANDS COMMUNITY HOSPITAL FAMILY CLINIC
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 802 W COLTON AVE STE E
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City | REDLANDS
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State | CA
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Zip | 92374-2905
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Country | US
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Telephone | 909-335-5799
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Fax |
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Provider Business Mailing Address
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Address Line | 350 TERRACINA BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-4850
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Country | US
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Telephone | 909-335-5505
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Fax | 909-335-6497
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MR. JAMES ROBERT HOLMES
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Credential |
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Telephone | 909-335-5505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | CA
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