Provider Demographics
NPI:1760774947
Name:LOMA LINDA UNIVERSITY
Entity Type:Organization
Organization Name:LOMA LINDA UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GME COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-558-8931
Mailing Address - Street 1:1234 ANDERSON STREET, GME OFFICE CSP 21005
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1234 ANDERSON STREET, GME OFFICE CSP 21005
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350
Practice Address - Country:US
Practice Address - Phone:909-558-8131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-06
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital