NPI | 1407513633 |
---|---|
Doing Business As | LOMA LINDA PSYCHIATRIC MEDICAL GROUP |
Entity Type | Organization |
Authorized Contact | LIBERTY MACIAS CEO 909-222-8912 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2021-11-22 |
Last Update Date | 2021-11-22 |