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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
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 |
Street Address |
25455 BARTON RD SUITE 206A |
City | LOMA LINDA |
State | CA |
Zip Code | 92354-3128 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 92354 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
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] |
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 |
Find all providers in LOMA LINDA |
City | LOMA LINDA |
Zip Code | 92354 |
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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.