Organization
RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.
Active
Other names
SOBOBA INDIAN CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEEVAN DHOUNI (DIRECTOR OF PHARMACY)
(909) 864-1097
Entity
Organization
Contact information
Practice address
23119 SOBOBA WAY, SAN JACINTO, CA 92583-5517
(951) 654-0803
(951) 654-9387
Mailing address
11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5172
(909) 864-1097
(951) 225-6879
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005498
PK
—
05
—
FHC03854F
—
CA
Enumeration date
05/30/2007
Last updated
09/11/2025
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