NPIMap

Organization Active NPI

San Bernardino County Department of Public Health

Doing business as C24-049 Hybrid Medical & Dental

  • State or Local Public Health Clinic/Center
  • San Bernardino, CA
National Provider Identifier
1447083217
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH
Doing business as
C24-049 Hybrid Medical & Dental
San Bernardino County Public Health Mobile Clinic
Practice address
451 E Vanderbilt Way
San Bernardino, CA 92408-3641
Phone
(909) 387-6625
NPI assigned
Aug 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Dr. Sharon Wang, DO
Title
Health Officer
Phone
(909) 387-6625

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X
State or Local Public Health Clinic/Center 261QP0905X Primary

Addresses

Primary practice location

451 E Vanderbilt Way
San Bernardino, CA 92408-3641

Mailing address

451 E Vanderbilt Way Ste 400
San Bernardino, CA 92408-3614
Phone (909) 387-6625

Other names 2

  • C24-049 Hybrid Medical & Dental Doing business as
  • San Bernardino County Public Health Mobile Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
San Bernardino County D142 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1447083217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 E VANDERBILT WAY STE 400",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083614",
            "telephone_number": "909-387-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083641",
            "telephone_number": "909-387-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "909-387-6625",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C24-049 Hybrid Medical & Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Bernardino County Public Health Mobile Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 16, 2024; 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.