SAN GORGONIO MEMORIAL HOSPITAL
NPI 1003939711
Skilled Nursing Facility in Banning, CA
NPI Status: Active since April 09, 2007
Contact Information
600 N HIGHLAND SPRINGS AVE
BANNING, CA
ZIP 92220
Phone: (951) 845-1121
Fax: (951) 469-0431
- Organization
- Skilled Nursing Facility
- CLIA Number: 05D0060931
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 01-02-2027
About SAN GORGONIO MEMORIAL HOSPITAL
This page provides the complete NPI Profile along with additional information for San Gorgonio Memorial Hospital, a provider established in Banning, California operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1003939711 assigned on April 2007. The practitioner's primary taxonomy code is 314000000X with license number CA250001668 (CA). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Mr. Jonathan Brenn (Ceo)
- NPI
- 1003939711
- Provider Name
- SAN GORGONIO MEMORIAL HOSPITAL
- Entity Type
- Organization
- Location Address
- 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220
- Location Phone
- (951) 845-1121
- Location Fax
- (951) 469-0431
- Mailing Address
- 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220
- Mailing Phone
- (951) 845-1121
- Mailing Fax
- (951) 469-0431
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-09-2007
- Last Update Date
- 08-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- CA250001668
- License State
- CA
- Taxonomy Description
- (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 555722 | OTHER (01) | CA | MEDICARE SNF PROVIDER NO |
| LTC555722F | OTHER (01) | CA | MEDICAID SNF PROVIDER NO |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0060931
- Facility Type
- Hospital
- Certificate Effective Date
- January 03, 2025
- Certificate Expiration Date
- January 02, 2027
- Laboratory Director
- MARK BECK, MD
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to San Gorgonio Memorial Hospital on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 0 | 3 | 9 | 3 | 9 | 7 | 1 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 18 | 3 | 18 | 7 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 1 + 8 + 3 + 1 + 8 + 7 + 2 + 24 = 59 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 59 = 1 | 1 | ||||||||
The NPI number 1003939711 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1255358974 | CAROL ROGALA D.O. Individual | Emergency Medicine | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (510) 350-2657 |
| 1013012921 | ARROWHEAD RADIOLOGY MEDICAL GROUP INC Organization | Radiology (Diagnostic Radiology) | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 845-1121 |
| 1861544967 | MR. DANIEL CHESLEY KIRK PT Individual | Physical Therapist (Orthopedic) | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 769-2135 |
| 1508815473 | DESERT ANESTHESIA CONSULTANTS LP Organization | Anesthesiology | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (818) 888-7815 |
| 1083954473 | SARAH CHAN PA-C Individual | Physician Assistant | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 845-1121 |
| 1861747172 | DR. MARIE DOLORES SAN ROMAN PHARMD Individual | Pharmacist | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 769-4888 |
| 1568469997 | SAN GORGONIO MEMORIAL HOSPITAL Organization | General Acute Care Hospital | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 845-1121 |
| 1336320167 | IGOR M BRON M D INC Organization | Anesthesiology | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 929-6260 |
| 1821460510 | TRANG TRACEY NGUYEN PHARMD. Individual | Pharmacist | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 845-1121 |
| 1750367546 | DR. MARK JOHN BECK M.D. Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 845-1121 |
| 1407189145 | CHRISTOPHER MICHAEL ROBERTSON PA-C Individual | Physician Assistant | 600 N HIGHLAND SPRINGS AVE EMERGENCY DEPARTMENT BANNING, CA 92220 (951) 769-2121 |
| 1063897890 | MS. BRIANNE WALTERS NABET MPA, PA-C Individual | Physician Assistant | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 845-1121 |
| 1386001212 | NORTH HIGHLAND INPATIENT SERVICE A MEDICAL CORP Organization | Hospitalist | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (469) 401-2386 |
| 1447800057 | HIGHLAND SPRINGS TELENEUROLOGY SERVICES A MEDICAL CORPORATION Organization | Psychiatry & Neurology (Neurology) | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (973) 251-1132 |
| 1144841214 | CALIFORNIA NEONATOLOGY SERVICES A MEDICAL CORPORATION Organization | Pediatrics (Neonatal-Perinatal Medicine) | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 845-1121 |
| 1174995385 | HA QUYEN THI ONG PHARM.D Individual | Pharmacist | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 769-4888 |
| 1477093714 | JENNIFER KAORI FUKASAWA-LARA PA-C Individual | Physician Assistant | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 845-1121 |
| 1881273852 | JOLEEN FAYE CHIACHI ESTRADA Individual | Registered Nurse | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (562) 221-5421 |
| 1871951798 | RITA CHANG MD Individual | Emergency Medicine | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 845-1121 |
| 1710419346 | DR. ERIN NOUD DO Individual | Emergency Medicine | 600 N HIGHLAND SPRINGS AVE BANNING, CA 92220 (951) 845-1121 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003939711, enumerated in the NPI registry as an "organization" on April 09, 2007
The provider is located at 600 N Highland Springs Ave Banning, Ca 92220 and the phone number is (951) 845-1121
This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 05D0060931 for a "hospital" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on April 09, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.