Organization
LOMA VIEW PEDIATRIC MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNESTO CRUZ M.D. (PRESIDENT)
(909) 475-5800
Entity
Organization
Contact information
Practice address
1684 PLUM LN, STE 101, REDLANDS, CA 92374-4596
(909) 475-5800
(909) 475-5805
Mailing address
1684 PLUM LN, STE 101, REDLANDS, CA 92374-4596
(909) 475-5800
(909) 475-5805
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
G49014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0051840
—
CA
Enumeration date
04/04/2007
Last updated
07/02/2015
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