Loma Linda Univ Urology Medical Group Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

LOMA LINDA UNIV UROLOGY MEDICAL GROUP INC

Practice address

26520 Cactus Ave
Moreno Valley, CA 92555

Phone

(909) 558-2830

Fax

(909) 558-3905

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

Herbert Ruckle, MD

Title

President Llu Urology Medical Group

Phone

(909) 558-2830

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871549477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE NUMBER 54701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-558-3111",
            "fax_number": "909-558-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "92555",
            "telephone_number": "909-558-2830",
            "fax_number": "909-558-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMA LINDA UNIV UROLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUCKLE",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_title_or_position": "PRESIDENT LLU UROLOGY MEDICAL GROUP",
        "authorized_official_telephone_number": "909-558-2830",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0056042",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stella J Locke, RN, IBCLC
• Destannie Lofton
• Logihealth
• Cindy Loh, MD
• Sheila Loharuka, D.O.
• Loma Linda University Children'S Hospital
• Christian Lomeli
• Esmeralda Lomeli, LCSW
• Arlene Adrienne Longoria
• Longs Drug Stores California LLC

• Urology Physician in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.