Healthcare Provider Details

I. General information

NPI: 1699866368
Provider Name (Legal Business Name): LINDA HYDER FERRY MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11201 BENTON ST
LOMA LINDA CA
92357-0001
US

IV. Provider business mailing address

37273 OAK GROVE RD
YUCAIPA CA
92399-9726
US

V. Phone/Fax

Practice location:
  • Phone: 909-583-6290
  • Fax: 909-777-3225
Mailing address:
  • Phone: 909-797-8079
  • Fax: 909-777-3225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberC41594
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberC41594
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: