Organization
LOMA LINDA UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY D NEAL (VICE CHANCELLOR--LOMA LINDA UNIV.)
(909) 558-4543
Entity
Organization
Contact information
Practice address
159 W HOSPITALITY LN STE 201, SAN BERNARDINO, CA 92408-3348
(909) 558-4616
(909) 651-3096
Mailing address
159 W HOSPITALITY LN STE 201, SAN BERNARDINO, CA 92408-3348
(909) 558-4616
(909) 651-3093
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2007
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G02000-02
—
CA
Enumeration date
12/28/2006
Last updated
11/27/2023
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