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General NPI Number Information
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NPI Number | 1760774947
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Entity Type | Organization
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Legal Business Name | LOMA LINDA UNIVERSITY
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Dates
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Enumeration Date | 05/06/2011
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Last Update Date | 05/06/2011
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Provider Practice Location Address
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Address Line | 1234 ANDERSON STREET, GME OFFICE CSP 21005
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City | LOMA LINDA
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State | CA
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Zip | 92350
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Country | US
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Telephone | 909-558-8131
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Fax |
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Provider Business Mailing Address
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Address Line | 1234 ANDERSON STREET, GME OFFICE CSP 21005
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City | LOMA LINDA
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State | CA
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Zip | 92350
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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 | GME COORDINATOR
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Name | MARILYN HOUGHTON
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Credential |
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Telephone | 909-558-8931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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