Provider Demographics
NPI:1336582964
Name:LOMA LINDA UNIVERSITY
Entity Type:Organization
Organization Name:LOMA LINDA UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OB GYN PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIDDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-558-6538
Mailing Address - Street 1:1659 E G ST APT 243
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-4488
Mailing Address - Country:US
Mailing Address - Phone:614-202-0161
Mailing Address - Fax:
Practice Address - Street 1:1659 E G ST APT 243
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4488
Practice Address - Country:US
Practice Address - Phone:614-202-0161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-13
Last Update Date:2013-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NW0100XHospitalsGeneral Acute Care HospitalWomen