# RIDGECREST REGIONAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ridgecrest Regional Hospital Rural Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972813087
- **Authorized official:** JAMES A SUVER (CEO)
- **Authorized official phone:** (760) 499-3900

## Contact information

- **Practice address:** 1111 N CHINA LAKE BLVD, RIDGECREST, CA 93555-3131
- **Practice address phone:** (760) 499-3855
- **Practice address fax:** (760) 499-3870
- **Mailing address:** 1081 N CHINA LAKE BLVD, RIDGECREST, CA 93555-3130
- **Mailing address phone:** (760) 499-3902
- **Mailing address fax:** (760) 446-2254

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 282NR1301X | Rural Acute Care Hospital | 120000186 | CA | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/08/2010
- **Last updated:** 04/13/2022