Loma Linda University Physicians Medical Group Inc | |
11370 Anderson St Ste 3150 Loma Linda CA 92354 | |
(909) 558-2191 | |
(909) 558-3905 |
Full Name | Loma Linda University Physicians Medical Group Inc |
---|---|
Speciality | Internal Medicine |
Location | 11370 Anderson St, Loma Linda, California |
Authorized Official Name and Position | James Couperus (PRESIDENT LLU PHYSICIANS MED GROUP) |
Authorized Official Contact | 9095582191 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Loma Linda University Physicians Medical Group Inc File Number 56994 Los Angeles CA 90074-6994 Ph: (909) 558-3111 | Loma Linda University Physicians Medical Group Inc 11370 Anderson St Ste 3150 Loma Linda CA 92354 Ph: (909) 558-2191 |
NPI Number | 1841230109 |
---|---|
Provider Enumeration Date | 06/07/2006 |
Last Update Date | 12/14/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841230109 | NPI | - | NPPES |
GR0040440 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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