SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT (NPI# 1245380799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245380799 |
| Entity Type | Organization |
| Organization Name | SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT |
| Other Organization Name | MOUNTAINS COMMUNITY HOSPITAL |
| Practice Address |
29101 Hospital Rd Lake Arrowhead CA 92352-0070 |
| Mailing Address |
Po Box 70 Lake Arrowhead CA 92352-0070 |
| Practice Telephone | 9093363651 |
| Practice Fax Number | 9093361179 |
| Mailing Telephone | 9093363651 |
| Mailing Fax Number | 9093361179 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2016-11-15 |
| Authorized Official Name | MR. CHARLES H. HARRISON (CEO) |
| Authorized Official Telephone | 9093363651 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
CGP160427 | CA | Hospitals |
| N | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
HSP40260I | CA | Hospitals |
| N | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
CGP171049 | CA | Hospitals |
| N | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
PHB366420 | CA | Hospitals |
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
HSP30260I | CA | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHB366420 | 05 | |
| CA | HSP30260I | 05 | |
| CA | HSP40260I | 05 | |
| CA | CGP171049 | 05 | |
| CA | CGP160427 | 05 |
| Other Name | Type Code |
|---|---|
| Mountains Community Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881703957 | San Bernardino Mountains Community Hospital District | Clinic/Center | 2642 Palo Alto, Running Springs, CA 92382 | 2006-08-30 |
| 1174674246 | San Bernardino Mountains Community Hospital District | Long Term Care Hospital | 29101 Hospital Rd, Lake Arrowhead, CA 92352-0070 | 2007-01-16 |
| 1073663662 | San Bernardino Mountains Community Hospital District | Medicare Defined Swing Bed Unit | 29101 Hospital Rd, Lake Arrowhead, CA 92352-0070 | 2007-01-12 |
| 1528172541 | San Bernardino Mountains Community Hospital District | Clinic/Center | 29099 Hospital Road, #200, Lake Arrowhead, CA 92352 | 2006-08-18 |
| Street Address |
29101 HOSPITAL RD |
| City | LAKE ARROWHEAD |
| State | CA |
| Zip Code | 92352-0070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154316297 | John Clarke Hankey | Emergency Medicine | 29101 Hospital Rd, Emergency Medicine Mountain Community Hospital, Lake Arrowhead, CA 92352-9706 | 2005-09-14 |
| 1225669005 | Sean K Benggon | Physical Therapist | 29101 Hospital Rd, Lake Arrowhead, CA 92352-9706 | 2020-01-30 |
| 1962047688 | Camille Evon Fuller | Physical Therapist | 29101 Hospital Rd, Lake Arrowhead, CA 92352-9706 | 2019-11-18 |
| 1174024244 | Danielle Summer Witt | Dental Hygienist | 29101 Hospital Rd, Lake Arrowhead, CA 92352-9706 | 2018-02-23 |
| 1962874594 | Darren Ream | Physical Therapist | 29101 Hospital Rd, Lake Arrowhead, CA 92352-9706 | 2015-10-22 |
| 1639598758 | Elite Hospitalist Medical Group, Inc. | Internal Medicine | 29101 Hospital Rd, Lake Arrowhead, CA 92352-9706 | 2014-04-16 |
| 1861828279 | Ara Tobar | Dental Hygienist | 29101 Hospital Rd, Lake Arrowhead, CA 92352-9706 | 2013-09-17 |
| 1326314048 | Mountains Comminity Hospital | General Acute Care Hospital | 29101 Hospital Rd, Suite 106, Lake Arrowhead, CA 92352-0070 | 2012-03-27 |
| 1326259284 | San Bernardino Mountains Community Hospital | Long Term Care Hospital | 29101 Hospital Rd, Lake Arrowhead, CA 92352 | 2007-05-24 |
| 1770708471 | Virginia (ginny) Dern Dunn | Physical Therapist | 29101 Hospital Rd, Suite 106, Lake Arrowhead, CA 92352-0070 | 2007-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952861239 | Elizabeth Kathleen White | Psychologist | 27307 State Hwy 189, #102, Lake Arrowhead, CA 92352 | 2019-03-22 |
| 1134699291 | Serenity Lodge, Inc | Substance Abuse Rehabilitation Facility | 974 Meadow Brook Road, Lake Arrowhead, CA 92352 | 2018-12-03 |
| 1952871014 | Serenity Lodge, Inc | Substance Abuse Rehabilitation Facility | 995 Meadow Brook Road, Lake Arrowhead, CA 92352 | 2018-12-03 |
| 1598235657 | Serenity Lodge, Inc | Substance Abuse Rehabilitation Facility | 1010 Meadow Brook Road, Lake Arrowhead, CA 92352 | 2018-12-03 |
| 1932674363 | Serenity Lodge, Inc | Substance Abuse Rehabilitation Facility | 27438 Nancy Drive, Lake Arrowhead, CA 92352 | 2018-10-12 |
| 1992294813 | Serenity Lodge, Inc | Substance Abuse Rehabilitation Facility | 1000 Pine Court, Lake Arrowhead, CA 92352 | 2018-05-07 |
| 1629567573 | Serenity Lodge, Inc | Substance Abuse Rehabilitation Facility | 1032 Cedar Lane, Lake Arrowhead, CA 92352 | 2018-05-07 |
| 1730638925 | Lake Arrowhead Recovery Center | Substance Abuse Rehabilitation Facility | 28729 Palisades Drive, Lake Arrowhead, CA 92352 | 2016-09-28 |
| 1366803140 | Carolyn Burnham | Registered Nurse | 157 Brentwood Drive, Lake Arrowhead, CA 92352 | 2016-03-08 |
| 1508226994 | Lisa Lynne Hower | Counselor | 26166 Circle Drive, Lake Arrowhead, CA 92352 | 2016-02-29 |
| Find all providers in zip 92352 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427486802 | Lake Arrowhead Physical Therapy | General Acute Care Hospital | 29099 Hospital Rd Suite 106, Lake Arrowhead, CA 92352-0070 | 2013-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407208713 | Moheb Youssef,m.d.,inc | General Acute Care Hospital | 5730 Glen Oaks Dr, La Verne, CA 91750-1713 | 2016-07-11 |
| 1659720373 | Pavel S. Volkov, M.d. Inc. | General Acute Care Hospital | 2393 E Strathmore Pl, Fresno, CA 93730-9717 | 2016-06-03 |
| 1841647575 | Ma Corazon Sabado Domine-flores | General Acute Care Hospital | 13884 Euclid St Apt B01, Garden Grove, CA 92843-3401 | 2016-05-23 |
| 1215305404 | Karen Samartan | General Acute Care Hospital | 6361 Varsity Dr, Huntington Beach, CA 92647-6544 | 2015-09-04 |
| 1841626587 | Adventist Health Clearlake Hospital, Inc | General Acute Care Hospital | 9430 Lake St, Lower Lake, CA 95457-8600 | 2013-09-25 |
| 1982948030 | Kern Medical Center | General Acute Care Hospital | 1420 H Street, Bakersfield, CA 93305 | 2012-11-15 |
| 1881960698 | Lisa M Bach Bohler | General Acute Care Hospital | 2202 N Magnolia Rd, Palm Springs, CA 92262-3652 | 2012-03-26 |
| 1750680914 | Cedars-sinai Medical Center | General Acute Care Hospital | 1650 Manning Ave, Los Angeles, CA 90024-5810 | 2011-03-26 |
| 1962705772 | Needles Hospital, Inc | General Acute Care Hospital | 1916 Desoto St, Needles, CA 92363-3023 | 2010-12-16 |
| 1558662098 | St. Joseph Health Northern California, LLC | General Acute Care Hospital | 248 Anzavista Ave, San Francisco, CA 94115 | 2010-11-16 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ARROWHEAD |
| Zip Code | 92352 |
Please comment or provide details below to improve the information on SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.