DR. RUSSELL IRVING CARL ERICKSON IV


Address: 25455 Barton Rd, Suite 206a, Loma Linda, CA 92354-3128
Phone: 9095581000

DR. RUSSELL IRVING CARL ERICKSON IV (NPI# 1376991059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376991059
Entity Type Individual
Full Name DR. RUSSELL IRVING CARL ERICKSON IV
Credential M.D.
Practice Address 25455 Barton Rd
Suite 206a
Loma Linda
CA 92354-3128
Mailing Address 11477 Benton St
Loma Linda
CA 92354-3682
Practice Telephone 9095581000
Practice Fax Number 9095586701
Mailing Telephone 5038664713
Enumeration Date 2016-06-02
Last Update Date 2016-06-02
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Other Providers RUSSELL ERICKSON

NPI Name Taxonomy Address Enumeration
1871591594 Russell C Erickson IIi Dentist 13530 Se 97th Ave, Clackamas, OR 97015-7691 2005-07-07
1538512066 Russell J Erickson Physical Therapist 150 W 100 N, Vernal, UT 84078-2036 2016-07-20

Office Location

Street Address 25455 BARTON RD
SUITE 206A
City LOMA LINDA
State CA
Zip Code 92354-3128

Providers in the same location

NPI Name Taxonomy Address Enumeration
1124018114 Gary D Botimer Orthopaedic Surgery 25455 Barton Rd, Ste 102b, Loma Linda, CA 92354-3128 2005-10-21
1033753249 Victoria V Teppone Family Medicine 25455 Barton Rd, Loma Linda, CA 92354-3128 2019-10-30
1164879219 Megan Ashley Olivas Registered Nurse 25455 Barton Rd, 204b, Loma Linda, CA 92354-3128 2016-05-18
1407202328 Tiffiny Suzanne Pizzifred Nurse Practitioner 25455 Barton Rd, Suite 204b, Loma Linda, CA 92354-3128 2016-05-10
1679943054 Rio Gutierrez Ocampo Nurse Practitioner 25455 Barton Rd, Suite 204b, Loma Linda, CA 92354-3128 2015-09-29
1164806329 Mark R Weber Physician Assistant 25455 Barton Rd, Loma Linda, CA 92354-3128 2015-07-16
1457731572 Mopelola Adetola Adeyemo Internal Medicine 25455 Barton Rd, Suite 206-a, Loma Linda, CA 92354-3128 2015-06-03
1073991287 Micah Clement Physician Assistant 25455 Barton Rd, Loma Linda, CA 92354-3128 2015-05-08
1952713802 Jack Pierre Dubois Family Medicine 25455 Barton Rd, Loma Linda, CA 92354 2014-05-27
1033554613 Loma Linda Inland Consortium for Healthcare Education Clinic/Center 25455 Barton Rd, Suite 209-b, Loma Linda, CA 92354-3128 2013-05-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1588264337 Apple Red Nutrition Services Dietitian, Registered 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 2020-10-30
1013517960 Kristina Pulliam Markey Nurse Practitioner 11234 Anderson Strreet, Loma Linda, CA 92354 2020-10-29
1932725645 Dev Priya Singhvi Student in an Organized Health Care Education/Training Program 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 2020-06-18
1750901278 Angela N Torres Student in an Organized Health Care Education/Training Program Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 2020-04-24
1548899230 Holistic Physical Therapy Inc. Physical Therapist 25003 Starr Str, Loma Linda, CA 92354 2020-04-03
1508494071 Eric Allen Student in an Organized Health Care Education/Training Program Loma Linda University Health Pediatrics, General, 11234 Anderson Street, Loma Linda, CA 92354 2020-03-31
1730640244 Rose Valley Rcfe Assisted Living Facility 11574 Poplar St, Loma Linda, CA 92354 2019-03-27
1336633676 David A Lawrence Student in an Organized Health Care Education/Training Program Loma Linda University Hospital, 11234 Anderson St., Loma Linda, CA 92354 2018-06-20
1205329547 Rachael Nicole Spady Student in an Organized Health Care Education/Training Program Loma Linda University Health - Obstetrics & Gynecology, 11234 Anderson St, Loma Linda, CA 92354 2018-06-12
1447756069 Anthony Ernest Sanchez Otolaryngology 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 2018-04-03
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Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1114544558 Frida Keeru Bundi Student in an Organized Health Care Education/Training Program Loma Linda University 11262 Campus Street-west Hall, Loma Linda, CA 92350-0001 2020-07-01
1508482035 Ella Wagner Student in an Organized Health Care Education/Training Program Loma Linda University 11262 Campus St- West Hall, Loma Linda, CA 92350-0001 2020-06-20
1932725645 Dev Priya Singhvi Student in an Organized Health Care Education/Training Program 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 2020-06-18
1376167643 Andrew J Park Student in an Organized Health Care Education/Training Program 26845 Barton Rd, Loma Linda, CA 92373-4309 2020-06-02
1689295263 Carlie Alphanso Smith Student in an Organized Health Care Education/Training Program Loma Linda University Health Primary Care -internal Med, 11234 Anderson St., Loma Linda, CA 92354-2804 2020-05-05
1750901278 Angela N Torres Student in an Organized Health Care Education/Training Program Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 2020-04-24
1396365599 Katielee Pallis Student in an Organized Health Care Education/Training Program Loma Linda University Evans Hall 201, Loma Linda, CA 92350-0001 2020-04-17
1639798879 Brian Fardad Yadegari Student in an Organized Health Care Education/Training Program 11234 Anderson Street Gme Office Westerly Suite C, Loma Linda, CA 92354-2804 2020-04-08
1316576895 Jason Elperin Student in an Organized Health Care Education/Training Program Loma Linda University Health-internal Medicine, 11234 Anderson Street, Loma Linda, CA 92354-2804 2020-04-06
1881223428 Masuma Javed Syed Student in an Organized Health Care Education/Training Program Loma Linda University Health- Internal Medicine, 11234 Anderson Street, Loma Linda, CA 92354-2804 2020-04-06
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Competitor

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City LOMA LINDA
Zip Code 92354

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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