Organization
COMMUNITY HEALTH SYSTEMS, INC.
Active
Other names
Bloomington Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
LORI NANETTE HOLEMAN (CEO)
(951) 571-2300
Entity
Organization
Contact information
Practice address
18601 VALLEY BLVD, BLOOMINGTON, CA 92316-1831
(909) 546-7520
(909) 877-5468
Mailing address
7880 MISSION GROVE PKWY S, RIVERSIDE, CA 92508-6000
(951) 571-2300
(951) 200-3063
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
40093
CA
1223G0001X
General Practice Dentistry
40996
CA
1223G0001X
General Practice Dentistry
46894
CA
1223P0221X
Pediatric Dentistry
47987
CA
152W00000X
Optometrist
OPT12626TPA
CA
207Q00000X
Family Medicine Physician
387455
CA
207Q00000X
Family Medicine Physician
506572
CA
207Q00000X
Family Medicine Physician
A110976
CA
207Q00000X
Family Medicine Physician
A1157855
CA
207Q00000X
Family Medicine Physician
A87726
CA
207Q00000X
Family Medicine Physician
A98737
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
240000086
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EAP70324F
—
CA
05
—
FHC70324F
—
CA
05
—
HAP70324F
—
CA
05
—
NPI 1487706347
—
CA
Enumeration date
01/18/2007
Last updated
04/17/2026
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