NPIMap

Organization Active NPI

Blood Bank of San Bernardino and Riverside Counties

  • Blood Bank
  • San Bernardino, CA
National Provider Identifier
1508157520
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Blood BankTaxonomy code 331L00000X
License
9021 Issued in CA
Legal business name
BLOOD BANK OF SAN BERNARDINO AND RIVERSIDE COUNTIES
Practice address
384 W Orange Show Rd
San Bernardino, CA 92408-2028
Phone
(909) 885-6503
Fax
(909) 381-2036
NPI assigned
Apr 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Authorized official

Name
Dr. Frederick B Axelrod, M.D. , MBA
Title
President/Ceo/Medical Director
Phone
(909) 885-6503

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLF3556 CA
Blood Bank 331L00000X 9021 CA Primary

Addresses

Primary practice location

384 W Orange Show Rd
San Bernardino, CA 92408-2028

Mailing address

PO Box 5729
San Bernardino, CA 92412-5729
Phone (909) 885-6503

Other names 1

  • LifeStream Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Blood Bank of San Bernardino and Riverside Counties2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1508157520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5729",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924125729",
            "telephone_number": "909-885-6503",
            "fax_number": "909-381-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 W ORANGE SHOW RD",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082028",
            "telephone_number": "909-885-6503",
            "fax_number": "909-381-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOD BANK OF SAN BERNARDINO AND RIVERSIDE COUNTIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "AXELROD",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "909-885-6503",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D. , MBA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF3556",
            "primary": false
        },
        {
            "code": "331L00000X",
            "taxonomy_group": "",
            "desc": "Blood Bank",
            "state": "CA",
            "license": "9021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeStream",
            "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 Apr 25, 2011; 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.