Loma Linda Surgical Institute, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LOMA LINDA SURGICAL INSTITUTE, LLC

Practice address

25915 Barton Road
Loma Linda, CA 92354

Phone

(714) 394-6465

NPI assigned

Feb 16, 2022

Last updated

Jul 31, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tammy Renell Tanner

Title

Admnistrator

Phone

(714) 394-6465

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Loma Linda Surgical Institute LLCCCN 55C0001155

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Bones Spine Surgery Inc

  • Medical Specialty Clinic/Center
  • Loma Linda, CA
  • NPI 1184013518

  Member Of

  NPD member
• Faculty Physicians and Surgeons of Llusm

  • Pediatric Cardiology Physician
  • Upland, CA
  • NPI 1912343104

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nikan H Khatibi, DO

  • Pain Medicine (Anesthesiology) Physician
  • Corona, CA
  • NPI 1326363300
  NPD (past)

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1730834904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 373",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923540373",
            "telephone_number": "714-394-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25915 BARTON ROAD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "714-394-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMA LINDA SURGICAL INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-16",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "RENELL",
        "authorized_official_title_or_position": "ADMNISTRATOR",
        "authorized_official_telephone_number": "714-394-6465"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loma Linda Optometry Inc
• Loma Linda Pharmacy Inc (Loma Linda Pharmacy)
• Loma Linda Recovery, LLC
• Loma Linda SNF Healthcare, LLC (Loma Linda Post Acute)
• Loma Linda Surgery Center, LLC
• Loma Linda Univ Anesthesiology Medical Group Inc
• Loma Linda Univ Family Medical Group Inc.
• Loma Linda Univ Urology Medical Group Inc
• Loma Linda Univeristy
• Loma Linda University

• Ambulatory Surgical Clinic/Center in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.