LOMA LINDA UNIVERSITY UROLOGY MEDICAL GROUP, INC.
NPI 1619104155
Urology in Beaumont, CA
NPI Status: Active since June 11, 2009
Contact Information
81 HIGHLAND SPRINGS AVE.
STE. 103
BEAUMONT, CA
ZIP 92223
Phone: (909) 558-2830
- Organization
- Urology
- CLIA Number: 05D1103180
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 05-05-2026
About LOMA LINDA UNIVERSITY UROLOGY MEDICAL GROUP, INC.
This page provides the complete NPI Profile along with additional information for Loma Linda University Urology Medical Group, Inc., a provider established in Beaumont, California operating as a Urology. The healthcare provider is registered in the NPI registry with number 1619104155 assigned on June 2009. The practitioner's primary taxonomy code is 208800000X. The provider is registered as an organization and their NPI record was last updated 16 years ago. Loma Linda University Urology Medical Group, Inc. operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Herbert Ruckle M.d. (President)
- NPI
- 1619104155
- Provider Name
- LOMA LINDA UNIVERSITY UROLOGY MEDICAL GROUP, INC.
- Entity Type
- Organization
- Location Address
- 81 HIGHLAND SPRINGS AVE. STE. 103 BEAUMONT, CA 92223
- Location Phone
- (909) 558-2830
- Mailing Address
- FILE # 54701 LOS ANGELES, CA 90074
- Mailing Phone
- (909) 558-3111
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-11-2009
- Last Update Date
- 06-19-2009
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Urology
- Taxonomy Code
- 208800000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D1103180
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- May 06, 2024
- Certificate Expiration Date
- May 05, 2026
- Laboratory Director
- DR. WESLEY T. STEVENS
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Loma Linda University Urology Medical Group, Inc. on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 1 | 9 | 1 | 0 | 4 | 1 | 5 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 2 | 9 | 2 | 0 | 8 | 1 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 2 + 9 + 2 + 0 + 8 + 1 + 1 + 0 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1619104155 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1518229806 | MARIAM MOGHADAM, M.D., INC. Organization | Family Medicine | 81 HIGHLAND SPRINGS AVE. SUITE #306 BEAUMONT, CA 92223 (951) 769-2222 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619104155, enumerated in the NPI registry as an "organization" on June 11, 2009
The provider is located at 81 Highland Springs Ave. Ste. 103 Beaumont, Ca 92223 and the phone number is (909) 558-2830
This medical organization specializes in Urology with taxonomy code 208800000X
The provider's CLIA number is 05D1103180 for a "skilled nursing facility/nursing facility" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on June 11, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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