Provider Demographics
NPI:1558156646
Name:LOMA VIEW REDLANDS PEDIATRIC MEDICAL CLINIC
Entity type:Organization
Organization Name:LOMA VIEW REDLANDS PEDIATRIC MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY HEALTH WORKER
Authorized Official - Prefix:MISS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:909-798-5599
Mailing Address - Street 1:1684 PLUM LN STE 101
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2866
Mailing Address - Country:US
Mailing Address - Phone:909-798-5599
Mailing Address - Fax:909-798-5595
Practice Address - Street 1:1684 PLUM LN STE 101
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2866
Practice Address - Country:US
Practice Address - Phone:909-798-5599
Practice Address - Fax:909-798-5595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health