| NPI | 1174676670 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2007-01-19 |
| Last Updated | 2021-08-25 |
| Authorized Official | William Thomsen CEO Phone: 9098641097 |
| Mailing Address | 11980 Mount Vernon Ave Grand Terrace, CA 92313-5172 United States Phone: (909) 864-1097 | Fax: (909) 744-3960 📍 View Map |
| Primary Practice Address | 11980 Mount Vernon Ave Grand Terrace, CA 92313-5172 United States Phone: (909) 864-1097 | Fax: (909) 744-3960 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | CA | FHC03869F | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 261QF0400X – Clinic/Center, Federally Qualified Health Center (FQHC) | CA | 240000751 |
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About NPI 1174676670
Riverside-San Bernardino County Indian Health, Inc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1174676670. The primary specialty listed is Clinic/Center, Federally Qualified Health Center (FQHC). The organization is located in Grand Terrace, CA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-01-19. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1174676670?
NPI 1174676670 belongs to Riverside-San Bernardino County Indian Health, Inc., a Clinic/Center, Federally Qualified Health Center (FQHC) in Grand Terrace, CA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1174676670 active?
The current status of NPI 1174676670 in the NPPES registry is Active. The record was last updated on 2021-08-25.
What specialty is NPI 1174676670?
NPI 1174676670 is classified under the taxonomy Clinic/Center, Federally Qualified Health Center (FQHC). Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1174676670?
You can verify NPI 1174676670 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1174676670?
The primary practice address on file for NPI 1174676670 is 11980 Mount Vernon Ave, Grand Terrace, CA 92313-5172. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1174676670 issued?
NPI 1174676670 was first issued (enumerated) on 2007-01-19. The NPPES record was last updated on 2021-08-25.
Practice Location Map
Riverside-San Bernardino County Indian Health, Inc. is located at 11980 Mount Vernon Ave, Grand Terrace, CA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Riverside-San Bernardino County Indian Health, Inc.. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1174676670. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Clinic/Center, Federally Qualified Health Center (FQHC) | 240000751 | CA |