Healthcare Provider Details

I. General information

NPI: 1295650869
Provider Name (Legal Business Name): LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22270 EUCALYPTUS AVENUE, SUITE 200
MORENO VALLEY CA
92553
US

IV. Provider business mailing address

11234 ANDERSON ST RM 1150
LOMA LINDA CA
92350-1716
US

V. Phone/Fax

Practice location:
  • Phone: 951-247-5809
  • Fax: 951-247-5609
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY ALAN HILLIARD
Title or Position: CEO
Credential:
Phone: 909-558-5075