Individual provider Active NPI

Bonnie Inquinn CHI-Lum, M.D.

  • Public Health & General Preventive Medicine Physician
  • Victorville, CA
National Provider Identifier
1467598219
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
G74540 Issued in CA
Practice address
15366 11TH St
Suite K
Victorville, CA 92395-3726
Phone
(909) 792-0001
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X G74540 CA Primary

Addresses

Primary practice location

15366 11TH St
Suite K
Victorville, CA 92395-3726

Mailing address

PO Box 457
Loma Linda, CA 92354-0457
Phone (909) 335-9242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110831000226 CA Practitioner - Preventive Medicine 2365333531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Loma Linda University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sac Health SystemGroup PAC ID 4385533579, 222 clinicians

Practice addresses (Care Compare)

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

488 S K St
San Bernardino, CA 92410-2641
Phone (909) 383-8092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 29, 2017 Accepting new patients
Sac Health System CurrentSince Jul 1, 2017 Accepting new patients
Sac Health System CurrentSince Jul 1, 2017 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 29, 2017 Accepting new patients

Locations

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Interoperability endpoints

  • Direct secure messaging: bchilum139240@direct.llu.edu

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sac Health System FrazeeSan Bernardino, CA, CCN 551156 Federally qualified health center Corporate Officer Jul 1, 2018
Sac Health System NortonSan Bernardino, CA, CCN 551175 Federally qualified health center Corporate Officer Jul 1, 2018
Sac Blythe MedicalBlythe, CA, CCN A01126 Federally qualified health center Corporate Officer Jul 1, 2018
Sac BarstowBarstow, CA, CCN A01127 Federally qualified health center Corporate Officer Jul 1, 2018

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467598219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923540457",
            "telephone_number": "909-335-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15366 11TH ST",
            "address_2": "SUITE K",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953726",
            "telephone_number": "909-792-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHI-LUM",
        "first_name": "BONNIE",
        "middle_name": "INQUINN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "G74540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.