| Organization Name: | RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. |
| NPI Number: | 1891169249 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BILL THOMSEN (CHIEF OPERATIONS OFFICER) |
| Mailing Address: | 11980 Mount Vernon Ave Grand Terrace |
| State: | CA US |
| Postal Code: | 923135172 |
| Phone Number: | 9098641097 |
| Fax Number: | |
| NPI Enumeration Date: | 11/23/2015 |
| NPI Last Update Date: | 11/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 240000751 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |