Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.
NPI 1720178478
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 October 13, 2006

11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313(909) 864-1097(951) 252-6879 Get Directions Write a Review

NPPES record last updated: July 7, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 7, 2026, Aug 24, 2021 (2 updates tracked since 2021).

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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 1720178478) is a healthcare organization registered as a federally qualified health center (fqhc) in Grand Terrace, California and active in the NPI registry since October 2006. The organization lists Mark Daniel Lebeau, Ceo, as its authorized official.

NPPES Registry Identity

NPI1720178478

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 (951) 225-6879

Phone(909) 864-1097

Fax(951) 252-6879

Organization SubpartNo

Authorized OfficialMark Daniel LebeauCeo · (909) 864-1097

Enumeration DateOctober 13, 2006

Last NPPES UpdateJuly 7, 20262 updates tracked since enumeration

NPPES CertifiedJuly 7, 2026

✔ NPI 1720178478 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

Licenses✔ Licensed in CA · 250000055✔ Licensed in CA · 240000751

11980 MOUNT VERNON AVE, Grand Terrace, CA 92313

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Other Identifiers 4

MedicaidFHC03869FCA

MedicaidFHC03854FCA

MedicaidFHC70271FCA

OtherEAP03854FCA · Eapc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

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.

NOEMI AVILA

Nurse Practitioner (Pediatrics)