Organization
LOMA LINDA UNIVERSITY UROLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT RUCKLE M.D. (GROUP DIRECTOR)
(909) 885-5150
Entity
Organization
Contact information
Practice address
400 N PEPPER AVE, UROLOGY DEPT-6TH FLOOR, COLTON, CA 92324-1801
(909) 885-5150
Mailing address
PO BOX 5157, SAN BERNARDINO, CA 92412-5157
(909) 885-5150
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
GR0056040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0056040
—
CA
01
—
ZZZ33529Z
MEDICARE GROUP NUMBER
—
Enumeration date
10/26/2007
Last updated
10/26/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up