Provider Demographics
NPI:1053071647
Name:BBDDD, INC
Entity Type:Organization
Organization Name:BBDDD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NINAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:909-831-1724
Mailing Address - Street 1:25780 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2507
Mailing Address - Country:US
Mailing Address - Phone:909-831-1724
Mailing Address - Fax:
Practice Address - Street 1:25780 MISSION RD
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2507
Practice Address - Country:US
Practice Address - Phone:909-831-1724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty