Healthcare Provider Details

I. General information

NPI: 1215623996
Provider Name (Legal Business Name): SHIVA VERMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST. LOMA LINDA UNIVERSITY MEDICAL CENTER
LOMA LINDA CA
92350
US

IV. Provider business mailing address

11234 ANDERSON ST.
LOMA LINDA CA
92350
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-7458
  • Fax: 909-558-6777
Mailing address:
  • Phone: 909-558-4000
  • Fax: 909-558-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: