San Gorgonio Memorial Hospital

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

CA250001668 Issued in CA

Legal business name

SAN GORGONIO MEMORIAL HOSPITAL

Practice address

600 N Highland Springs Ave
Banning, CA 92220-3046

Phone

(951) 845-1121

Fax

(951) 469-0431

NPI assigned

Apr 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jonathan Brenn

Title

Ceo

Phone

(951) 769-2100

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thuan Thi Nguyen, LCSW

  • Clinical Social Worker
  • Palm Springs, CA
  • NPI 1285123133
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003939711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N HIGHLAND SPRINGS AVE",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203046",
            "telephone_number": "951-845-1121",
            "fax_number": "951-469-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HIGHLAND SPRINGS AVE",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203046",
            "telephone_number": "951-845-1121",
            "fax_number": "951-469-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GORGONIO MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRENN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-769-2100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "CA250001668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SNF PROVIDER NO",
            "identifier": "555722",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID SNF PROVIDER NO",
            "identifier": "LTC555722F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Salazar
• Manuel I Salmeron, MD
• San Gorgonio Memorial Health Care District
• San Gorgonio Memorial Health Care District
• San Gorgonio Memorial Health Care District
• San Gorgonio Memorial Hospital
• Marie Dolores San Roman, PHARMD
• Lisa L. Sanborn
• Bianca Sanchez, ASCW
• Juan Francico Sanchez

• Skilled Nursing Facility in Banning, CA
• Providers in Banning, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.