Individual provider Active NPI

Matthew A Grube, MD

  • Diagnostic Radiology Physician
  • Loma Linda, CA
National Provider Identifier
1710180468
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A108508 Issued in CA
Practice address
11201 Benton St
Mail Code: 114
Loma Linda, CA 92357-1000
Phone
(909) 558-8131
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A108508 CA Primary

Addresses

Primary practice location

11201 Benton St
Mail Code: 114
Loma Linda, CA 92357-1000

Mailing address

11201 Benton St
Mail Code: 114
Loma Linda, CA 92357-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A108508CAMDDiagnostic Radiology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1710180468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "address_2": "MAIL CODE: 114",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923571000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "address_2": "MAIL CODE: 114",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923571000",
            "telephone_number": "909-558-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBE",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A108508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.