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General NPI Number Information
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NPI Number | 1285837468
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Entity Type | Organization
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Legal Business Name | LOMA LINDA UNIVERSITY MEDICAL CENTER
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11750 MOUNT VERNON AVE # N251
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City | GRAND TERRACE
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State | CA
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Zip | 92313-8202
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Country | US
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Telephone | 909-824-5156
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Fax |
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Provider Business Mailing Address
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Address Line | 11750 MT VERNON AVE N251
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City | GRAND TERRACE
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State | CA
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Zip | 92313
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | JIAHCHIAHN SHELIA HSU
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Credential | MD
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Telephone | 90098245156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | A95434
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License Number State | CA
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