NPIMap

Organization Active NPI

Riverside-San Bernardino County Indian Health, Inc.

Doing business as Soboba Indian Clinic Pharmacy

  • Clinic Pharmacy
  • San Jacinto, CA
National Provider Identifier
1487855045
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.
Doing business as
Soboba Indian Clinic Pharmacy
Practice address
23119 Soboba Way
San Jacinto, CA 92583-5517
Phone
(951) 654-0803
Fax
(951) 654-9387
NPI assigned
May 30, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Jeevan Dhouni
Title
Director of Pharmacy
Phone
(909) 864-1097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

23119 Soboba Way
San Jacinto, CA 92583-5517

Mailing address

11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone (909) 864-1097

Other names 1

  • SOBOBA INDIAN CLINIC PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rsbcihi20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

23119 Soboba Rd
San Jacinto, CA 92583
Phone (951) 654-0803

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1487855045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135172",
            "telephone_number": "909-864-1097",
            "fax_number": "951-225-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23119 SOBOBA WAY",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925835517",
            "telephone_number": "951-654-0803",
            "fax_number": "951-654-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2025-09-11",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "DHOUNI",
        "authorized_official_first_name": "JEEVAN",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "909-864-1097"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOBOBA INDIAN CLINIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.