San Bernardino Health Medical Group Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

0A705510 Issued in CA

Legal business name

SAN BERNARDINO HEALTH MEDICAL GROUP INC

Practice address

5365 Walnut Ave
A
Chino, CA 91710-2622

Phone

(909) 591-1743

Fax

(909) 591-1744

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Duong Thieu Phung, M.D.NPI 1588725659

Title

OB/GYN

Phone

(909) 591-1743

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

San Bernardino Health Medical Group Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• San Bernardino Women's Health Medical Group, Inc.

  • Specialist
  • Chino, CA
  • NPI 1033142278
  NPD tax ID

Practitioners 1

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

• Duong Thieu Phung, M.D.

  • Gynecology Physician
  • Chino, CA
  • NPI 1588725659
  NPD Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194731588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5365 WALNUT AVE",
            "address_2": "A",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102622",
            "telephone_number": "909-591-1743",
            "fax_number": "909-591-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5365 WALNUT AVE",
            "address_2": "A",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102622",
            "telephone_number": "909-591-1743",
            "fax_number": "909-591-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN BERNARDINO HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHUNG",
        "authorized_official_first_name": "DUONG",
        "authorized_official_middle_name": "THIEU",
        "authorized_official_title_or_position": "OB/GYN",
        "authorized_official_telephone_number": "909-591-1743",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "0A705510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A705510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharlene Salgado
• Sam's Club Optical (Sam's Club Optical 30-6610)
• Sambangi and Rodgers Dental Corporation (Chino Smiles Dental Group)
• Sams West Inc (Sams Pharmacy 10-6610)
• San Bernardino County Department of Behavioral Health Chino Multipe Di
• San Bernardino Hospice LLC
• San Bernardino Women's Health Medical Group, Inc.
• Natalie Elena San Gil
• Ana Sanchez
• Jaselynn Sanchez

• Specialist in Chino, CA
• Providers in Chino, CA by specialty
• Specialist 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.