MEDICARE: COMMUNITY HEALTH SYSTEMS INC

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	A114857	CA
2	207V00000X	Obstetrics & Gynecology Physician	350902	CA
3	207V00000X	Obstetrics & Gynecology Physician	LM235	CA
4	2084P0800X	Psychiatry Physician	A102033	CA
5	207Q00000X	Family Medicine Physician	A78623	CA
6	207Q00000X	Family Medicine Physician	7619	CA
7	207V00000X	Obstetrics & Gynecology Physician	A63365	CA
8	1223G0001X	General Practice Dentistry	52428	CA
9	2084N0400X	Neurology Physician	A115342	CA
10	207R00000X	Internal Medicine Physician	C36017	CA
11	207Q00000X	Family Medicine Physician	C53673	CA
12	207Q00000X	Family Medicine Physician	A90249	CA
13	152W00000X	Optometrist	OPT5169TPA	CA
14	207V00000X	Obstetrics & Gynecology Physician	1846	CA
15	261QF0400X	Federally Qualified Health Center (FQHC)	080000150	CA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CK277B	OTHER	CA	MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	BCP70275G	OTHER	CA	BCDEP
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1982756086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH SYSTEMS INC

Provider Business Mailing Address
First Line	:	7880 MISSION GROVE PKWY S
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-6000
Country	:	US
Telephone Number	:	951-571-2300
Fax Number	:	951-571-2330

Provider Business Practice Location Address
First Line	:	1328 S MISSION RD
Second Line	:
City	:	FALLBROOK
State	:	CA
Zip	:	92028-4006
Country	:	US
Telephone Number	:	760-451-4720
Fax Number	:	760-451-4700

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	JACK E JOHNS
Credential	:
Telephone Number	:	951-571-2300

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	03/05/2026

1374 S MISSION RD STE 408
FALLBROOK, CA
92028-4006

Practice Phone: 951-698-4650
Practice Fax: