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Organization
LOMA LINDA UNIVERSITY PHYSICIANS MEDICAL GROUP INC
Active
Organization
LOMA LINDA UNIVERSITY PHYSICIANS MEDICAL GROUP INC
Active
Parent organization
LOMA LINDA UNIVERSITY PHYSICANS MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOMA LINDA UNIVERSITY PHYSICANS MEDICAL GROUP
Authorized official
JAMES COUPERUS MD (PRESIDENT LLU PHYSICIANS MED GROUP)
(909) 558-2191
Entity
Organization
Contact information
Practice address
11375 ANDERSON ST, LOMA LINDA, CA 92354
(909) 558-2624
(909) 558-3905
Mailing address
FILE NUMBER 56994, LOS ANGELES, CA 90074-6994
(909) 558-3111
(909) 558-3905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0040445
—
CA
Enumeration date
05/25/2006
Last updated
12/14/2007
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