| NPI | 1083791644 |
|---|---|
| Doing Business As | LOMA LINDA DERMATOLOGY MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KENNETH D MACKNET Vice President 909-796-0224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-03-16 |