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General NPI Number Information
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NPI Number | 1851395685
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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 | 06/09/2005
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 1676 MEDICAL CENTER DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1213
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Country | US
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Telephone | 909-887-6481
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Fax | 909-887-3858
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Provider Business Mailing Address
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Address Line | 1676 MEDICAL CENTER DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1213
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Country | US
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Telephone | 909-887-6481
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Fax | 909-887-3858
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Authorized Official
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Title or Position | V.P. FIANANCE, CFO
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Name | MR. ED SORENSON
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Credential |
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Telephone | 909-887-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 240000185
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License Number State | CA
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