Jerry L. Pettis Memorial Va Medical Center

Specialty details in registry · Loma Linda, CA

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At a glance

11201 Benton St, Loma Linda, CA 92357-1000

NPPES record updated Aug 22, 2020. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

11201 Benton St
Loma Linda, CA 92357-1000
Professional details: NPI, taxonomy & registry record
NPI1275691594
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
284300000X
Enumeration date
Dec 6, 2006
Record updated
Aug 22, 2020
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

284300000X · Primary

License reported: G03312 LA

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

11201 Benton St
Loma Linda, CA 92357-1000
Phone
(909) 825-7084
Mailing address
116 N PLYMOUTH WAY

SAN BERNARDINO, CA 924084116
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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