Loma Linda University Radiology Medical Group Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

LOMA LINDA UNIVERSITY RADIOLOGY MEDICAL GROUP INC

Practice address

25455 Barton Road
Ste 107B
Loma Linda, CA 92354

Phone

(909) 558-3012

NPI assigned

Jun 7, 2006

Organization subpart

No

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

Addresses

Other identifiers 1

Locations

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": "1881634145",
    "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": "25455 BARTON ROAD",
            "address_2": "STE 107B",
            "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0011164",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loma Linda University Physicians Medical Group Inc
• Loma Linda University Radiation Medicine
• Loma Linda University Radiology Medical Group Inc
• Loma Linda University Radiology Medical Group Inc
• Loma Linda University Radiology Medical Group Inc
• Loma Linda University School of Dentistry
• Loma Linda University School of Dentistry
• Loma Linda VA Medical Center
• Loma Linda Vamc
• Loma Linda Vamc

• Diagnostic Radiology Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Diagnostic Radiology Physician in California

• 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.