Organization
LOMA LINDA UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY DALE NEAL (SR. VICE PRESIDENT)
(909) 558-4543
Entity
Organization
Contact information
Practice address
11092 ANDERSON ST., LOMA LINDA, CA 92354
(909) 558-4613
Mailing address
11092 ANDERSON ST., LOMA LINDA, CA 92354
(909) 558-4613
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
2034
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G01010-03
—
CA
Enumeration date
12/28/2006
Last updated
03/18/2020
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