Active NPI
Loma Linda University Physicians Medical Group Inc
- Internal Medicine Physician
- Loma Linda, CA
National Provider Identifier
1154377075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- LOMA LINDA UNIVERSITY PHYSICIANS MEDICAL GROUP INC
- Practice address
- 11375 Anderson St
Loma Linda, CA 92354 - Phone
- (909) 558-2624
- Fax
- (909) 558-3905
- NPI assigned
- May 25, 2006
- Organization subpart
- Yes
- Parent organization
- LOMA LINDA UNIVERSITY PHYSICANS MEDICAL GROUP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James Couperus, MD
- Title
- President Llu Physicians Med Group
- Phone
- (909) 558-2191
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
11375 Anderson St
Loma Linda, CA 92354
Mailing address
File Number 56994
Los Angeles, CA 90074-6994
Phone (909) 558-3111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0040445 | Medicaid | CA |
National Provider Directory
National Provider Directory- Part of
- Loma Linda University P
Locations
File Number 56994
Los Angeles, CA 90074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1197590400000",
"number": "1154377075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE NUMBER 56994",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900746994",
"telephone_number": "909-558-3111",
"fax_number": "909-558-3905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11375 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "92354",
"telephone_number": "909-558-2624",
"fax_number": "909-558-3905"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOMA LINDA UNIVERSITY PHYSICIANS MEDICAL GROUP INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LOMA LINDA UNIVERSITY PHYSICANS MEDICAL GROUP",
"enumeration_date": "2006-05-25",
"last_updated": "2007-12-14",
"status": "A",
"authorized_official_last_name": "COUPERUS",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "PRESIDENT LLU PHYSICIANS MED GROUP",
"authorized_official_telephone_number": "909-558-2191",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0040445",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
- Loma Linda University Medical Center
- Loma Linda University Medical Center
- Loma Linda University Medical Center
- Loma Linda University Pathology Medical Group, Inc.
- Loma Linda University Pathology Medical Group, Inc.
- Loma Linda University Physicians Medical Group Inc
- Loma Linda University Physicians Medical Group Inc
- Loma Linda University Radiation Medicine
- Loma Linda University Radiology Medical Group Inc
- Loma Linda University Radiology Medical Group Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.