Organization
COMMUNITY HEALTH SYSTEMS, INC.
Active
Other names
Inland Empire Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOBBY VASCOVICH (CHIEF EXECUTIVE OFFICER)
(909) 877-1818
Entity
Organization
Contact information
Practice address
18601 VALLEY BLVD, BLOOMINGTON, CA 92316-1831
(909) 877-1818
(909) 746-0400
Mailing address
18601 VALLEY BLVD, BLOOMINGTON, CA 92316-1831
(909) 877-1818
(909) 746-0400
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
080000150
CA
261QF0400X
Federally Qualified Health Center (FQHC)
240000086
CA
261QF0400X
Federally Qualified Health Center (FQHC)
250000756
CA
261QF0400X
Federally Qualified Health Center (FQHC)
250000807
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70275G
—
CA
05
—
FHC70324F
—
CA
05
—
FHC70865F
—
CA
05
—
FHC71040F
—
CA
01
—
G98054-01
DELTA DENTAL
CA
01
—
G98054-02
DELTA DENTAL
CA
01
—
G98054-03
DELTA DENTAL
CA
01
—
HAP70275G
FAMILY PACT
CA
01
—
HAP70324F
FAMILY PACT
CA
01
—
HAP70865F
FAMILY PACT
CA
Enumeration date
07/05/2005
Last updated
08/22/2020
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