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Organization

LOMA LINDA UNIVERSITY UROLOGY MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HERBERT RUCKLE M.D. (PRESIDENT)
(909) 558-2830
Entity
Organization

Contact information

Practice address
81 HIGHLAND SPRINGS AVE., STE. 103, BEAUMONT, CA 92223-2511
(909) 558-2830
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Enumeration date
06/11/2009
Last updated
06/19/2009
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