Healthcare Provider Details

I. General information

NPI: 1720660020
Provider Name (Legal Business Name): ELIZABETH RUTH BYRD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST
LOMA LINDA CA
92350-1716
US

IV. Provider business mailing address

11234 ANDERSON ST # MC A890
LOMA LINDA CA
92350-1716
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4344
  • Fax:
Mailing address:
  • Phone: 909-558-7171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number20A23743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: