Active NPI
Samuel David Fox
- Psychiatry Physician
- Loma Linda, CA
National Provider Identifier
1720830730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A206104
- Practice address
- 11234 Anderson St
Loma Linda, CA 92354-2804 - Phone
- (909) 558-9532
- NPI assigned
- Apr 3, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A206104 | CA | Primary |
Addresses
Primary practice location
11234 Anderson St
Loma Linda, CA 92354-2804
Mailing address
11234 Anderson Street
Gme Office Westerly Suite C
Loma Linda, CA 92354-2804
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A206104 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763683200000",
"number": "1720830730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11234 ANDERSON STREET",
"address_2": "GME OFFICE WESTERLY SUITE C",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804",
"telephone_number": "909-558-9532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOX",
"first_name": "SAMUEL",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-03",
"last_updated": "2025-11-21",
"certification_date": "2025-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A206104",
"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 Nov 21, 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.