NPIMap

Organization Active NPI

Crestview Convalescent Hospital

  • Skilled Nursing Facility
  • Rialto, CA
National Provider Identifier
1255340592
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
240000134 Issued in CA
Legal business name
CRESTVIEW CONVALESCENT HOSPITAL
Practice address
1471 S Riverside Ave
Rialto, CA 92376-7703
Phone
(909) 877-0854
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Roy V Berglund, MD
Title
Owner
Phone
(909) 877-1361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 240000134 CA Primary

Addresses

Primary practice location

1471 S Riverside Ave
Rialto, CA 92376-7703

Mailing address

1471 S Riverside Ave
Rialto, CA 92376-7703
Phone (909) 877-0854

National Provider Directory

National Provider Directory
Tax ID family
Crestview Convalescent Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1255340592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 S RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923767703",
            "telephone_number": "909-877-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 S RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923767703",
            "telephone_number": "909-877-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW CONVALESCENT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "BERGLUND",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-877-1361",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "240000134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.