# LOMA LINDA UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982760757
- **Authorized official:** MR. RODNEY DALE NEAL (SR. VICE PRESIDENT)
- **Authorized official phone:** (909) 558-4543

## Contact information

- **Practice address:** 11092 ANDERSON ST., LOMA LINDA, CA 92354
- **Practice address phone:** (909) 558-4613
- **Mailing address:** 11092 ANDERSON ST., LOMA LINDA, CA 92354
- **Mailing address phone:** (909) 558-4613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 2034 | CA | Yes |

## Other

- **Enumeration date:** 12/28/2006
- **Last updated:** 03/18/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | G01010-03 | — | CA |