NPIMap

Organization Active NPI

Sac Health System

  • Family Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1043721939
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
450731 Issued in CA
Legal business name
SAC HEALTH SYSTEM
Practice address
250 S G St
San Bernardino, CA 92410-3320
Phone
(909) 382-7100
Fax
(909) 382-7115
NPI assigned
Oct 18, 2017
Last updated
Oct 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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

Authorized official

Name
Angela Teresi
Title
Human Resource Supervisior
Phone
(909) 771-2764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 450731 CA Primary

Addresses

Primary practice location

250 S G St
San Bernardino, CA 92410-3320

Mailing address

250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508284800000",
    "number": "1043721939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "909-382-7100",
            "fax_number": "909-382-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "909-382-7100",
            "fax_number": "909-382-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAC HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-18",
        "last_updated": "2017-10-18",
        "status": "A",
        "authorized_official_last_name": "TERESI",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "HUMAN RESOURCE SUPERVISIOR",
        "authorized_official_telephone_number": "909-771-2764"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "450731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; 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.