NPIMap

Organization Active NPI

Loma Linda University Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Loma Linda, CA
National Provider Identifier
1841230190
Registry record updated Nov 20, 2007
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Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LOMA LINDA UNIVERSITY RADIOLOGY MEDICAL GROUP INC
Practice address
11234 Anderson St
Loma Linda, CA 92354
Phone
(909) 558-3012
NPI assigned
Jun 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2007

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

Authorized official

Name
Gerald Kirk, MD
Title
Cfo Llu Radiology Medical Group Inc
Phone
(909) 558-3012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354

Mailing address

PO Box 30959
Los Angeles, CA 90030-0959
Phone (909) 558-3012

Other identifiers 1

IdentifierTypeStateIssuer
GR0011162MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1841230190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30959",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900300959",
            "telephone_number": "909-558-3012",
            "fax_number": "909-558-3292"
        },
        {
            "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": "92354",
            "telephone_number": "909-558-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMA LINDA UNIVERSITY RADIOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "CFO LLU RADIOLOGY MEDICAL GROUP INC",
        "authorized_official_telephone_number": "909-558-3012",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0011162",
            "state": "CA"
        }
    ],
    "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 20, 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.

Verify at the official NPI Registry.