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Organization

BLOOD BANK OF SAN BERNARDINO AND RIVERSIDE COUNTIES

Active
Other names
LifeStream
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FREDERICK B AXELROD M.D. , MBA (PRESIDENT/CEO/MEDICAL DIRECTOR)
(909) 885-6503
Entity
Organization

Contact information

Practice address
384 W ORANGE SHOW RD, SAN BERNARDINO, CA 92408-2028
(909) 885-6503
(909) 381-2036
Mailing address
PO BOX 5729, SAN BERNARDINO, CA 92412-5729
(909) 885-6503
(909) 381-2036

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
CLF3556
CA
331L00000X
Blood Bank
Primary
9021
CA

Other

Enumeration date
04/25/2011
Last updated
04/25/2011
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