Provider Demographics
NPI:1750404430
Name:JOSEPH L VANDERLINDEN MD INC
Entity type:Organization
Organization Name:JOSEPH L VANDERLINDEN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERLINDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-881-7200
Mailing Address - Street 1:399 E HIGHLAND AVE STE 319
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-3858
Mailing Address - Country:US
Mailing Address - Phone:909-881-7200
Mailing Address - Fax:909-881-7289
Practice Address - Street 1:1766 N RIVERSIDE AVE STE A
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-8085
Practice Address - Country:US
Practice Address - Phone:909-881-7200
Practice Address - Fax:909-881-7289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80388208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G803880Medicaid
CA00G803880Medicaid
CAZZZ02916ZMedicare PIN