| Riverside-san Bernardino County Indian Health, Inc. | |
|
11555 Potrero Rd Banning CA 92220-6946 | |
| (951) 849-4761 | |
| (951) 849-5612 |
| Full Name | Riverside-san Bernardino County Indian Health, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 11555 Potrero Rd, Banning, California |
| Authorized Official Name and Position | Linwood J. Killam (CEO) |
| Authorized Official Contact | 9518494761 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside-san Bernardino County Indian Health, Inc. 11555 Potrero Rd Banning CA 92220-6946 Ph: (951) 849-4761 | Riverside-san Bernardino County Indian Health, Inc. 11555 Potrero Rd Banning CA 92220-6946 Ph: (951) 849-4761 |
| NPI Number | 1841417300 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841417300 | NPI | - | NPPES |
| EAPC03854F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Riverside-san Bernardino County Indian Health, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11555 1/2 Potrero Rd, Banning, CA 92220 Phone: 951-849-4761 Fax: 951-849-5612 | |
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