Provider Demographics
NPI:1265648018
Name:VA HOSPITAL LOMA LINDA
Entity Type:Organization
Organization Name:VA HOSPITAL LOMA LINDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ERNST
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-583-6009
Mailing Address - Street 1:4850 BLUE COPPER WAY
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-8938
Mailing Address - Country:US
Mailing Address - Phone:951-775-7276
Mailing Address - Fax:
Practice Address - Street 1:VA HOSPITAL LOMA LINDA
Practice Address - Street 2:11201 BENTON ST.
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92357-0001
Practice Address - Country:US
Practice Address - Phone:909-583-6009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital