Active NPI
San Gorgonio Memorial Health Care District
- Family Medicine Physician
- Banning, CA
National Provider Identifier
1801761358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- SAN GORGONIO MEMORIAL HEALTH CARE DISTRICT
- Practice address
- 264 N Highland Springs Ave Ste 3D
Banning, CA 92220-3085 - Phone
- (951) 951-2762
- Fax
- (951) 848-7985
- NPI assigned
- Oct 6, 2025
- Last updated
- Oct 6, 2025
- Organization subpart
- Yes
- Parent organization
- SAN GORGONIO MEMORIAL HEALTH CARE DISTRICT
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Angela Brady
- Title
- Exeutive
- Phone
- (951) 769-2121
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
264 N Highland Springs Ave Ste 3D
Banning, CA 92220-3085
Mailing address
264 N Highland Springs Ave Ste 3D
Banning, CA 92220-3085
Phone (951) 951-2762
National Provider Directory
National Provider Directory- Part of
- San Gorgonio Pass Mem
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Beaumont, CA
- NPI 1689098832
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": "1759708800000",
"number": "1801761358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "264 N HIGHLAND SPRINGS AVE STE 3D",
"city": "BANNING",
"state": "CA",
"postal_code": "922203085",
"telephone_number": "951-951-2762",
"fax_number": "951-848-7985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 N HIGHLAND SPRINGS AVE STE 3D",
"city": "BANNING",
"state": "CA",
"postal_code": "922203085",
"telephone_number": "951-951-2762",
"fax_number": "951-848-7985"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAN GORGONIO MEMORIAL HEALTH CARE DISTRICT",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SAN GORGONIO MEMORIAL HEALTH CARE DISTRICT",
"enumeration_date": "2025-10-06",
"last_updated": "2025-10-06",
"certification_date": "2025-10-06",
"status": "A",
"authorized_official_last_name": "BRADY",
"authorized_official_first_name": "ANGELA",
"authorized_official_title_or_position": "EXEUTIVE",
"authorized_official_telephone_number": "951-769-2121"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Banning, CA
- Desiree Alexis Salazar
- Melanie Salazar
- Manuel I Salmeron, MD
- San Gorgonio Memorial Health Care District (San Gorgonio Memorial Medical Clinic)
- San Gorgonio Memorial Health Care District
- San Gorgonio Memorial Hospital
- San Gorgonio Memorial Hospital
- Marie Dolores San Roman, PHARMD
- Lisa L. Sanborn
- Bianca Sanchez, ASCW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.