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General NPI Number Information
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NPI Number | 1821813197
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Entity Type | Organization
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Legal Business Name | COUNTY OF SAN BERNARDINO
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 900 E GILBERT ST # 3
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City | SAN BERNARDINO
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State | CA
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Zip | 92415-0911
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Country | US
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Telephone | 909-387-5841
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Fax |
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Provider Business Mailing Address
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Address Line | 175 W 5TH ST FL 4
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City | SAN BERNARDINO
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State | CA
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Zip | 92415-0430
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HEALTH SERVICES MANAGER
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Name | CARLOS PEACE
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Credential |
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Telephone | 909-387-5878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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