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Contact Information

LOMA LINDA UNIV UROLOGY MEDICAL GROUP INC
11370 ANDERSON ST
STE 1100
LOMA LINDA, CA92354
 Phone: 909-558-2830
 Fax: 909-558-3905
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Urology

208800000X 34 Physician/Urology
Indicates primary specialty

NPI Profile & details for LOMA LINDA UNIV UROLOGY MEDICAL GROUP INC

NPI # 1396791901
LBN Legal business name LOMA LINDA UNIV UROLOGY MEDICAL GROUP INC
Authorized official HERBERT RUCKLE - (PRESIDENT LLU UROLOGY MEDICAL GROUP)
Entity Organization
Organization subpart 1 No
Enumeration date 05/25/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
CA Medicaid GR0041730
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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