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Organization

DEPARTMENT OF BEHAVIORAL HEALTH, SAN BERNARDINO COUNTY CA

Active
Other names
Victorville Multidiagnosis Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL J. DAY (INFORMATION TECHNOLOGY MANAGER)
(909) 388-0570
Entity
Organization

Contact information

Practice address
12625 HESPERIA RD, VICTORVILLE, CA 92395-7720
(909) 382-3080
(909) 382-3105
Mailing address
268 W HOSPITALITY LN, SUITE 400, SAN BERNARDINO, CA 92415-0001
(909) 382-3080
(909) 382-3105

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
ZZZ74743Z
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
36AC
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
05/22/2007
Last updated
08/22/2020
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