Organization
SAC HEALTH SYSTEM
Active
Parent organization
SAC HEALTH SYSTEM
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAC HEALTH SYSTEM
Authorized official
TASHA AMICK (DIRECTOR OF BILLING)
(909) 382-7100
Entity
Organization
Contact information
Practice address
815 S WILLOW AVE, RIALTO, CA 92376-6934
(909) 382-7100
(909) 382-7101
Mailing address
815 S WILLOW AVE, RIALTO, CA 92376-6934
(909) 382-7100
(909) 382-7101
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMM70708F
—
CA
01
—
EAP70708F
EAPC
CA
01
—
ENVOY3000
ENVOY SITE ID
CA
Enumeration date
05/14/2020
Last updated
04/21/2025
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