Healthcare Provider Details

I. General information

NPI: 1275768350
Provider Name (Legal Business Name): RICHEL YOLANDI STRYDOM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24785 STEWART ST STE 204
LOMA LINDA CA
92350-1721
US

IV. Provider business mailing address

24785 STEWART ST STE 204
LOMA LINDA CA
92350-1721
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4918
  • Fax: 909-558-0451
Mailing address:
  • Phone: 909-558-4918
  • Fax: 909-558-0451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberA127315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: