Provider Demographics
NPI:1447083217
Name:SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH
Entity type:Organization
Organization Name:SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:909-387-6625
Mailing Address - Street 1:451 E VANDERBILT WAY STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3614
Mailing Address - Country:US
Mailing Address - Phone:909-387-6625
Mailing Address - Fax:
Practice Address - Street 1:451 E VANDERBILT WAY
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3641
Practice Address - Country:US
Practice Address - Phone:909-387-6625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251K00000XAgenciesPublic Health or Welfare