Provider Demographics
NPI:1962566679
Name:LOMA LINDA UNIVERSITY
Entity type:Organization
Organization Name:LOMA LINDA UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VICE CHANCELLOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VERLON
Authorized Official - Middle Name:W
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, MBA
Authorized Official - Phone:909-558-4543
Mailing Address - Street 1:11145 ANDERSON ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-0001
Mailing Address - Country:US
Mailing Address - Phone:909-558-4543
Mailing Address - Fax:909-558-0355
Practice Address - Street 1:11145 ANDERSON ST
Practice Address - Street 2:SUITE 205
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-0001
Practice Address - Country:US
Practice Address - Phone:909-558-4543
Practice Address - Fax:909-558-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center