Sac Health System
Organization Active NPI Federally Qualified Health Center (FQHC) · Barstow, CA
NPI 1699449496 · NPPES record last updated Apr 21, 2025
Key facts
- NPI
- 1699449496
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- SAC HEALTH SYSTEM
- Practice address
- 801 E Mountain View St
Barstow, CA 92311-3053 - Phone
- (909) 382-7100
- Fax
- (909) 382-7101
- NPI assigned
- Aug 4, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- SAC HEALTH SYSTEM
Authorized official
- Name
- Tasha Amick
- Title
- Director of Billing
- Phone
- (909) 382-7100
Owners & managing parties with NPI records 3
-
Bonnie Inquinn CHI-Lum, M.D.
-
Richard H. Hart, M.D.
-
Jason Lee Lohr, M.D.
Other NPIs with the same Medicare PAC ID 12
Corporate family (same tax ID) 17
Practitioners 222
-
Amir Abdi Pour, MD
-
Dmitry Abramov, M.D.
-
Sana Afroz, MD
-
Wendy Celines Alberty, MSN, APRN, FNP-C
-
Pedro Alvarez, MD
-
Mohammd Reza Amini, M.D.
-
Sanaz Amini, M.D.
-
James Kieran Amsberry, M.D.
-
Tania Arous, MD
-
Sarah Maged Azer, MD
-
Josianne Kayleigh Wolter Bailey, MD, MBA
-
Nancy A Baker, MD
-
Khazenay Bakhsh, DO
-
Firas Bannout, M.D
-
Christian Bardan, MD
-
Leon Bathini Jr., MD
-
David Stephen Benjamin, M.D.
-
Richa Bhattarai, M.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Federally qualified health center certification: CCN A01127
- Legal name
- SAC HEALTH SYSTEM
- Doing business as
- SAC BARSTOW
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Nov 17, 2022
- Last certification
- Nov 17, 2022
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 5, 1995 in CA
- Enrollment address
- 801 E Mountain View St
Barstow, CA 92311-3053
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Peter J Baker |
Corporate Director |
Feb 22, 2022 | |
| Angela Teresi |
W-2 Managing Employee |
Jun 29, 2015 | |
| Jason Lohr |
Corporate Officer |
Jun 29, 2018 | |
| Luisa Loubriel |
Corporate Director |
Feb 22, 2022 | |
| Eric Ngo |
Corporate Director |
Mar 1, 2010 | |
| Bonnie I CHI Lum |
Corporate Officer |
Jul 1, 2018 | |
| Pat Morris |
Corporate Director |
Sep 24, 2019 | |
| Raul Castillo |
Corporate Director |
Apr 1, 2014 | |
| Richard Henry Hart |
Corporate Director |
Jul 1, 2014 | |
| Edith Ann Atkinson |
Corporate Director |
Mar 1, 2010 | |
| Maryellen R Westerberg |
Corporate Officer |
Jul 1, 2018 | |
| Rodney Neal |
Corporate Director |
Sep 1, 2014 | |
| John B Skelton |
Corporate Officer |
Apr 8, 2019 | |
| Jessica Garcia |
Corporate Director |
Feb 22, 2022 | |
| Marilyn Hermann |
Corporate Director |
Mar 1, 2010 | |
| Ken Ramirez |
Corporate Director |
Jan 26, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221201002514 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 4385533579 | Practice locations: Barstow, CA |
National Provider Directory
- Tax ID family
- Sac Health System Norto
- Part of
- Sac Health System Norto
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
801 E Mountain View St
Barstow, CA 92311-3053
Mailing address
250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100
Other providers in Barstow, CA
- RPM Rehab, Inc.
- RRSH Medical Inc
- Holly Rudd
- Sac Health System
- Sac Health System
- Anurag Sahai
- Adam Julian Salas
- Salman Dental
- Asad H Salman
- San Bernardino County DBH
All providers in Barstow, CA · Federally Qualified Health Center (FQHC) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.