Active NPI
St. Bernardine Surgery Center, Inc.
- Phlebology Physician
- San Bernardino, CA
National Provider Identifier
1366615486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebology Physician
- Legal business name
- ST. BERNARDINE SURGERY CENTER, INC.
- Practice address
- 1869 N Waterman Ave
Suite 200
San Bernardino, CA 92404-4830 - Phone
- (909) 886-6911
- NPI assigned
- Apr 9, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pedro Soriano Alupay, M.D.
- Title
- President
- Phone
- (909) 886-6911
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebology Physician | 202K00000X | Primary | ||
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | |||
| Anesthesiology Physician | 207L00000X | |||
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | |||
| Dermatology Physician | 207N00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Gastroenterology Physician | 207RG0100X | |||
| Gynecology Physician | 207VG0400X | |||
| Orthopaedic Surgery Physician | 207X00000X | |||
| Surgery Physician | 208600000X | |||
| Interventional Pain Medicine Physician | 208VP0014X |
Addresses
Primary practice location
1869 N Waterman Ave
Suite 200
San Bernardino, CA 92404-4830
Mailing address
1869 N Waterman Ave
Suite 200
San Bernardino, CA 92404-4830
Phone (909) 886-6911
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207699200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1207699200000",
"number": "1366615486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1869 N WATERMAN AVE",
"address_2": "SUITE 200",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924044830",
"telephone_number": "909-886-6911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1869 N WATERMAN AVE",
"address_2": "SUITE 200",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924044830",
"telephone_number": "909-886-6911"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. BERNARDINE SURGERY CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-04-09",
"last_updated": "2008-04-09",
"status": "A",
"authorized_official_last_name": "ALUPAY",
"authorized_official_first_name": "PEDRO",
"authorized_official_middle_name": "SORIANO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "909-886-6911",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "202K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Phlebology",
"state": null,
"license": null,
"primary": true
},
{
"code": "204E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Oral & Maxillofacial Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology, Pain Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": null,
"license": null,
"primary": false
}
],
"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 Apr 9, 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.