RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. (NPI# 1841417300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841417300 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. |
| Other Organization Name | MORONGO INDIAN HEALTH CLINIC |
| Practice Address |
11555 Potrero Rd Banning CA 92220-6946 |
| Practice Telephone | 9518494761 |
| Practice Fax Number | 9518495612 |
| Mailing Telephone | 9518494761 |
| Mailing Fax Number | 9518495612 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. LINWOOD J. KILLAM (CEO) |
| Authorized Official Telephone | 9518494761 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | EAPC03854F | 05 |
| Other Name | Type Code |
|---|---|
| Morongo Indian Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043363641 | Riverside-san Bernardino County Indian Health, Inc. | Clinic/Center | 66735 Martinez Rd, Thermal, CA 92274-9007 | 2007-01-19 |
| 1659424885 | Riverside-san Bernardino County Indian Health, Inc. | Clinic/Center | 39100 Contreras Rd, Suite C, Anza, CA 92539-8724 | 2007-01-19 |
| 1891169249 | Riverside-san Bernardino County Indian Health, Inc. | Clinic/Center | 11980 Mount Vernon Ave, Grand Terrace, CA 92313-5172 | 2015-11-23 |
| 1174676670 | Riverside-san Bernardino County Indian Health, Inc. | Clinic/Center | 11980 Mount Vernon Ave, Grand Terrace, CA 92313-5172 | 2007-01-19 |
| 1639222144 | Riverside-san Bernardino County Indian Health, Inc. | Clinic/Center | 607 Donna Way, San Jacinto, CA 92583-5517 | 2007-01-19 |
| Street Address |
11555 POTRERO RD |
| City | BANNING |
| State | CA |
| Zip Code | 92220-6946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144350984 | John Francis Sheehan | Counselor | 11555 Potrero Rd, Herbert Mcmichael, Ph.d., Banning, CA 92220-6946 | 2007-03-07 |
| 1962524405 | Phung Minh Vu | Dentist | 11555 Potrero Rd, Banning, CA 92220-6946 | 2007-04-04 |
| 1144349549 | Jean T Dinh | Optometrist | 11555 Potrero Rd, Banning, CA 92220-6946 | 2007-03-28 |
| 1578694758 | Allen Saul | Counselor | 11555 Potrero Rd, Banning, CA 92220-6946 | 2007-03-08 |
| 1689705675 | Francis Anthony Robichaud | Counselor | 11555 Potrero Rd, Banning, CA 92220-6946 | 2007-03-08 |
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|---|---|---|---|---|
| 1962056523 | Golden View Guest Home, Inc. | Assisted Living Facility | 5466 West Wilson, Banning, CA 92220 | 2019-07-31 |
| 1780246157 | Fjs Hearing Professionals | Hearing Instrument Specialist | 3559 W Ramsey Ave Suit C-2, Banning, CA 92220 | 2019-07-05 |
| 1790237832 | Jennifer De Geus | Counselor | 1627 Hargrave St., Banning, CA 92220 | 2016-10-25 |
| 1427447507 | Dalonna Blackwell | Counselor | 2781 W. Ramsey St., Banning, CA 92220 | 2015-01-13 |
| 1639575962 | Eunjung J. Jung Choi | Dentist | 300 S Highland Springs Ave Ste 2l, Banning, CA 92220 | 2014-11-13 |
| 1861810244 | Genevra Diana Glenn | Counselor | 2781 W Ramsey, Suite 1, Banning, CA 92220 | 2014-04-02 |
| 1841617420 | Kristen Lew | Internal Medicine | 6109 W.ramsey Street, Banning, CA 92220 | 2014-03-21 |
| 1588917884 | Jamison William Murphy | Military Health Care Provider | Uss Howard Ddg 83, Fpo, AP 92220 | 2012-10-24 |
| 1972871390 | John Hong | Pharmacist | 60 N Highlandsprings, Beaumont, CA 92220 | 2011-12-13 |
| 1679855936 | Lydia Session | Marriage & Family Therapist | 1627 S. Hargrave, Banning, CA 92220 | 2011-09-13 |
| Find all providers in zip 92220 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1629601653 | Rancho Paseo Medical Group Operated By Neighborhood Healthcare | Clinic/Center | 264 N Highland Springs Ave Ste 4, Banning, CA 92220-3082 | 2020-02-18 |
| 1437202124 | Riverside-san Bernardino County Indian Health, Inc | Clinic/Center | 11555 1/2 Potrero Rd, Banning, CA 92220-6946 | 2007-01-18 |
| 1720178478 | Riverside/san Bernardino County Indian Health, Inc. | Clinic/Center | 11555 1/2 Potrero Rd, Banning, CA 92220-6946 | 2006-10-13 |
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| 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.