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NPI Code Detail

MEDICARE: VIBRA HOSPITAL OF SAN BERNARDINO, LLC

MEDICARE: VIBRA HOSPITAL OF SAN BERNARDINO, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1283X00000XRehabilitation Hospital240000502CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2120321000OTHERDEPT OF LABOR
3ZZZH3608ZOTHERBLUE SHIELD

General Provider Information

NPI Number : 1497748081
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIBRA HOSPITAL OF SAN BERNARDINO, LLC
Provider Business Mailing Address
First Line : PO BOX 26657
Second Line :
City : FRESNO
State : CA
Zip : 93729-6657
Country : US
Telephone Number : 559-892-2500
Fax Number : 559-892-2444
Provider Business Practice Location Address
First Line : 1760 W 16TH ST
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92411-1160
Country : US
Telephone Number : 909-473-1200
Fax Number : 909-473-1276
Authorized Official
Title or Position : PRESIDENT
Name : MR. BRAD EUGENE HOLLINGER
Credential :
Telephone Number : 717-591-5700
Provider Enumeration Date : 08/29/2005
Last Update Date : 10/10/2023

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Directions to “VIBRA HOSPITAL OF SAN BERNARDINO, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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