| Loma Linda Psychiatric Medical Group | |
|
26070 Lugo Dr Loma Linda CA 92354-6507 | |
| (909) 894-4260 | |
| (888) 505-0620 |
| Full Name | Loma Linda Psychiatric Medical Group |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 26070 Lugo Dr, Loma Linda, California |
| Authorized Official Name and Position | Liberty Macias (PARTNER) |
| Authorized Official Contact | 9098944260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loma Linda Psychiatric Medical Group 26070 Lugo Dr Loma Linda CA 92354-6507 Ph: () - | Loma Linda Psychiatric Medical Group 26070 Lugo Dr Loma Linda CA 92354-6507 Ph: (909) 894-4260 |
| NPI Number | 1750835013 |
|---|---|
| Provider Enumeration Date | 08/04/2016 |
| Last Update Date | 08/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750835013 | NPI | - | NPPES |
| 127629 | Other | CA | UIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 56486 (California) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 95002264 (California) | Secondary |
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