Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.
NPI 1174676670
Clinic/Center - Federally Qualified Health Center (FQHC) in Grand Terrace, CA

Q: What is Riverside-San Bernardino County Indian Health, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since January 19, 2007

11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313(909) 864-1097(909) 744-3960 Get Directions Write a Review

NPPES record last updated: July 7, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 7, 2026, Aug 25, 2021, Mar 5, 2021 and 1 more (4 updates tracked since 2016).

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About Riverside-san Bernardino County Indian Health, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. (NPI 1174676670), doing business as San Manuel Indian Health, is a healthcare organization registered as a federally qualified health center (fqhc) in Grand Terrace, California and active in the NPI registry since January 2007. The organization lists Mark Daniel Lebeau, Ceo, as its authorized official.

NPPES Registry Identity

NPI1174676670

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameRIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.

Location Address11980 MOUNT VERNON AVEGrand Terrace, CA 92313-5172

Mailing Address11980 Mount Vernon AveGrand Terrace, CA 92313-5172 · (909) 864-1097 · Fax (909) 744-3960

Phone(909) 864-1097

Fax(909) 744-3960

Organization SubpartNo

Authorized OfficialMark Daniel LebeauCeo · (909) 864-1097

Enumeration DateJanuary 19, 2007

Last NPPES UpdateJuly 7, 20264 updates tracked since enumeration

NPPES CertifiedJuly 7, 2026

✔ NPI 1174676670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

License✔ Licensed in CA · 240000751

11980 MOUNT VERNON AVE, Grand Terrace, CA 92313

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Other Names 1

Doing Business AsSan Manuel Indian Health

Other Identifiers 1

MedicaidFHC03869FCA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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