Douglas Soderblom, O.D.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

10169TG Issued in CA

Legal business name

DOUGLAS SODERBLOM, O.D.

Doing business as

Loma Linda Optometry

Practice address

25815 Barton Rd
Suite 104
Loma Linda, CA 92354-3893

Phone

(909) 478-3345

Fax

(909) 478-9337

NPI assigned

Feb 3, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Soderblom, O.D.

Title

Owner

Phone

(909) 478-3345

Specialties & licenses 1

Addresses

Other names 1

• Loma Linda Optometry Doing business as

Locations

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

{
    "created_epoch": "1359849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359849600000",
    "number": "1811236490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25815 BARTON RD",
            "address_2": "SUITE 104",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543893",
            "telephone_number": "909-478-3345",
            "fax_number": "909-478-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25815 BARTON RD",
            "address_2": "SUITE 104",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543893",
            "telephone_number": "909-478-3345",
            "fax_number": "909-478-9337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS SODERBLOM, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-03",
        "last_updated": "2013-02-03",
        "status": "A",
        "authorized_official_last_name": "SODERBLOM",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-478-3345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "10169TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loma Linda Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kip Dooley, MD
• Daniel Alexander Dorius, MD
• Ihab R Dorotta, M.D.
• Hildemar Feliciano Dos Santos, DRPH CNS
• Jonathan Patrick Dougherty, PSYD
• Diah Amelia Douglas, M.D.
• Sarah Maria Downes, DMD
• William Michael Downes, MD
• Christina Denise Downey, M.D.
• John Downtain, RN

• Primary Care Clinic/Center in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2013; 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.