NPIMap

Organization Active NPI

Crossover Health Medical Group

Doing business as Crossover @ San Bernardino

  • Multi-Specialty Clinic/Center
  • San Bernardino, CA
National Provider Identifier
1982211835
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CROSSOVER HEALTH MEDICAL GROUP
Doing business as
Crossover @ San Bernardino
Practice address
711 W 2ND St Ste a
San Bernardino, CA 92410-3262
Phone
(949) 891-0328
NPI assigned
Sep 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Authorized official

Name
Angie Sakioka
Title
Operations
Phone
(949) 891-0228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

711 W 2ND St Ste a
San Bernardino, CA 92410-3262

Mailing address

101 W Avenida Vista Hermosa Ste 120
San Clemente, CA 92672-7707
Phone (949) 891-0328

Other names 1

  • Crossover @ San Bernardino Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2198730Crossover Health Medical Group, Apc711A W 2ND Street, San Bernardino, CA 92410Certificate of waiverNov 3, 2026

National Provider Directory

National Provider Directory
Tax ID family
Crossover Medical Group89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

711 W 2nd St
Ste A
San Bernardino, CA 92410

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1982211835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W AVENIDA VISTA HERMOSA STE 120",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926727707",
            "telephone_number": "949-891-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W 2ND ST STE A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103262",
            "telephone_number": "949-891-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSOVER HEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "SAKIOKA",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "OPERATIONS",
        "authorized_official_telephone_number": "949-891-0228"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossover @ San Bernardino",
            "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 Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.