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General NPI Number Information
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NPI Number | 1235290818
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Entity Type | Organization
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Legal Business Name | COMMUNITY HOSPITAL OF SAN BERNARDINO
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 01/26/2015
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Provider Practice Location Address
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Address Line | 1805 MEDICAL CENTER DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1217
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Country | US
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Telephone | 909-887-6333
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Fax | 909-806-1017
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Provider Business Mailing Address
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Address Line | 1805 MEDICAL CENTER DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1217
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Country | US
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Telephone | 909-887-6333
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Fax | 909-806-1017
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Authorized Official
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Title or Position | CFO
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Name | DARRYL VANDENBOSCH
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Credential |
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Telephone | 909-881-7196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 240000198
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 240000198
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | HSP37939
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 240000198
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License Number State | CA
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