| Loma Linda University Physicians Medical Group Inc | |
|
11375 Anderson St Loma Linda CA 92354 | |
| (909) 558-2624 | |
| (909) 558-3905 |
| Full Name | Loma Linda University Physicians Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11375 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 11375 Anderson St Loma Linda CA 92354 Ph: (909) 558-2624 |
| NPI Number | 1154377075 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 12/14/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154377075 | NPI | - | NPPES |
| GR0040445 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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