Organization Active NPI

San Gorgonio Memorial Health Care District

  • Family Medicine Physician
  • Banning, CA
National Provider Identifier
1669347233
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAN GORGONIO MEMORIAL HEALTH CARE DISTRICT
Practice address
600 N Highland Springs Ave
Banning, CA 92220-3046
Phone
(909) 264-0246
Fax
(951) 845-2836
NPI assigned
Oct 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
John Peleuses
Title
VP Ancillary and Support Services
Phone
(909) 264-0246

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X

Addresses

Primary practice location

600 N Highland Springs Ave
Banning, CA 92220-3046

Mailing address

600 N Highland Springs Ave
Banning, CA 92220-3046
Phone (909) 264-0246

National Provider Directory

National Provider Directory

Locations

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

NPI Registry JSON

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

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1669347233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N HIGHLAND SPRINGS AVE",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203046",
            "telephone_number": "909-264-0246",
            "fax_number": "951-845-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HIGHLAND SPRINGS AVE",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203046",
            "telephone_number": "909-264-0246",
            "fax_number": "951-845-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GORGONIO MEMORIAL HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "PELEUSES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP ANCILLARY AND SUPPORT SERVICES",
        "authorized_official_telephone_number": "909-264-0246"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Banning, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.