Organization
LOMA LINDA UNIVERSITY RADIATION MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY SLATER MD (PRESIDENT)
(909) 558-3014
Entity
Organization
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354
(909) 558-3012
(909) 558-3905
Mailing address
PO BOX 30969, LOS ANGELES, CA 90030-0969
(909) 558-3012
(909) 558-3292
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0063620
—
CA
Enumeration date
05/25/2006
Last updated
08/22/2020
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