MR. ROGER MICHAEL GUSTAFSON (NPI# 1396766077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396766077 |
| Entity Type | Individual |
| Full Name | MR. ROGER MICHAEL GUSTAFSON |
| Credential | N.P. |
| Practice Address |
11201 Benton St Loma Linda CA 92357-1000 |
| Mailing Address |
1270 Mohave Dr Colton CA 92324-4740 |
| Practice Telephone | 9098257084 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
475764 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11201 BENTON ST |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92357-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841290558 | Russell Evan Hoxie Jr. | Internal Medicine | 11201 Benton St, Loma Linda, CA 92357-1000 | 2005-07-22 |
| 1104435643 | Megan Satre | Audiologist | 11201 Benton St, Loma Linda, CA 92357-1000 | 2020-07-30 |
| 1972111862 | Aileen Nati Ludesirishoti | Pharmacist | 11201 Benton St, Loma Linda, CA 92357-1000 | 2020-07-17 |
| 1649894551 | Bryan Lamont Brewer | Social Worker | 11201 Benton St, Loma Linda, CA 92357-1000 | 2020-06-05 |
| 1518580497 | Nicole Kaye Whittle | Audiologist | 11201 Benton St, Loma Linda, CA 92357-1000 | 2020-05-26 |
| 1629690375 | Kevin Alan Cox | Student in an Organized Health Care Education/Training Program | 11201 Benton St, Loma Linda, CA 92357-1000 | 2020-05-15 |
| 1033731443 | Joni Lynn Stanton | Registered Nurse | 11201 Benton St, Loma Linda, CA 92357-1000 | 2020-05-08 |
| 1134748536 | Abednego Tamba | Registered Nurse | 11201 Benton St, Loma Linda, CA 92357-1000 | 2020-04-15 |
| 1447885884 | Zachary Michael Cruz | Registered Nurse | 11201 Benton St, Loma Linda, CA 92357-1000 | 2020-03-05 |
| 1972141695 | Tanya Lengvilas | Pharmacist | 11201 Benton St, Loma Linda, CA 92357-1000 | 2019-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679916027 | Nicole Kristine Shah-ghassemzadeh | Internal Medicine | Jerry L. Pettis Memorial Veterans Hospital - Gastroente, 11201 Benton Street, Loma Linda, CA 92357 | 2013-04-16 |
| 1760628598 | Taranjit Natt | Internal Medicine | 11201 Benton St # 111-om, Loma Linda, CA 92357 | 2008-12-29 |
| 1548355076 | Annette A Boyd -hampton | Nurse Practitioner | 11201 Benton St. -111g, Loma Linda, CA 92357 | 2006-10-03 |
| 1396830766 | Maudie Cantrell Foy | Nurse Practitioner | 11201 Benton St. (11cp), Loma Linda, CA 92357 | 2006-10-03 |
| 1427154715 | Kenneth Wong | Pharmacist | 11201 Benton St. (119), Loma Linda, CA 92357 | 2006-09-15 |
| 1801909577 | Paul Lindberg | Orthotist | 11201 Benton St./121, Loma Linda, CA 92357 | 2006-08-16 |
| 1992728703 | Harry Chen | Pharmacist | 11201 Benton Street, Va Loma Linda Healthcare System (119), Loma Linda, CA 92357 | 2006-07-25 |
| 1699222661 | Nathanial Benjaman Hawkins | Psychologist | 11201 Benton Street, Bhost 116a, Loma Linda, CA 92357 | 2016-09-07 |
| 1063877959 | Irene Thung | Pathology | 11201 Benton Street, Dept. of Pathology (113), Loma Linda, CA 92357 | 2015-12-21 |
| 1033553375 | Brian Chau | Physical Medicine & Rehabilitation | 11201 Benton Street, Department of Pm&r (mail Code 117), Loma Linda, CA 92357 | 2013-04-17 |
| Find all providers in zip 92357 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548355076 | Annette A Boyd -hampton | Nurse Practitioner | 11201 Benton St. -111g, Loma Linda, CA 92357 | 2006-10-03 |
| 1396830766 | Maudie Cantrell Foy | Nurse Practitioner | 11201 Benton St. (11cp), Loma Linda, CA 92357 | 2006-10-03 |
| 1003927385 | Christine Eunice Kurunathan | Nurse Practitioner | 11034 Veach St, Loma Linda, CA 92354-6528 | 2006-08-31 |
| 1528383528 | Megan Jonee Volkov | Nurse Practitioner | 24785 Stewart St, Loma Linda, CA 92354-2751 | 2010-04-01 |
| 1730203456 | Pamela Ann Esquivel | Nurse Practitioner | 11234 Anderson St, Suite A220, Loma Linda, CA 92354-2804 | 2007-03-19 |
| 1306974209 | Nancy Fritz Meert | Nurse Practitioner | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2007-03-01 |
| 1235264953 | Thomas Joseph Sweeney | Nurse Practitioner | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2007-02-22 |
| 1871628453 | Lisa Bolla | Nurse Practitioner | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2007-02-22 |
| 1801901285 | Iberay Fisher | Nurse Practitioner | 11201 Benton St, Loma Linda, CA 92357-1000 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699388504 | Daniel Ngo | Nurse Practitioner | 1180 S Hilda St, Anaheim, CA 92806-5007 | 2020-08-28 |
| 1407464522 | Laura Bradigan | Nurse Practitioner | 1744 Grand Ave Unit 2, Long Beach, CA 90804-2022 | 2020-07-15 |
| 1538787031 | Kelly Olcott | Nurse Practitioner | 4004 Via Lucero Apt 12, Santa Barbara, CA 93110-1692 | 2020-07-10 |
| 1629695440 | Kelley Ibarra | Nurse Practitioner | 1613 Celeste Dr, Modesto, CA 95355-5039 | 2020-06-26 |
| 1497379333 | Gloria Jean Campbell | Nurse Practitioner | 5055 E Garford St Apt 6, Long Beach, CA 90815-2861 | 2020-06-06 |
| 1851913115 | Lilly Fong | Nurse Practitioner | 15821 Square Top Ln, Fontana, CA 92336-4586 | 2020-05-09 |
| 1548880750 | Sharkeiya Terrell | Nurse Practitioner | 2752 Harrison Ave Ste A, Eureka, CA 95501-4738 | 2020-04-17 |
| 1730714007 | Julissa Leonides Caraballo | Nurse Practitioner | 4044 Promontory St, San Diego, CA 92109-5334 | 2020-03-07 |
| 1194355404 | Bethany Leda Donowho | Nurse Practitioner | 845 Via De La Paz Ste 16, Pacific Palisades, CA 90272-3627 | 2020-01-26 |
| 1518507078 | Rachel Saake Collar | Nurse Practitioner | 5100, 1000 Executive Pkwy, Oroville, CA 95966 | 2020-01-13 |
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| City | LOMA LINDA |
| Zip Code | 92357 |
Please comment or provide details below to improve the information on MR. ROGER MICHAEL GUSTAFSON.
| 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.