| Douglas J Van Putten, MD,FACS | |
|
11370 Anderson St # 1800, Loma Linda, CA 92354-3450 | |
| (909) 558-2154 | |
| (909) 558-2180 |
| Full Name | Douglas J Van Putten |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology |
| Experience | 40 Years |
| Location | 11370 Anderson St # 1800, Loma Linda, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851378558 | NPI | - | NPPES |
| 01039408A | Other | IN | PHYSICIAN LICENSE |
| 100335580 | Medicaid | IN | |
| 000000342157 | Other | IN | ANTHEM BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | 01039408A (Indiana) | Secondary |
| 208200000X | Plastic Surgery | 01039408A (Indiana) | Secondary |
| 207W00000X | Ophthalmology | G58345 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Loma Linda University Medical Center | Loma linda, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Faculty Physicians And Surgeons Of Llusm | 1153227814 | 1153 |
| Entity Name | Faculty Physicians And Surgeons Of Llusm |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas J Van Putten, MD,FACS 11370 Anderson St # 1800, Loma Linda, CA 92354-3450 Ph: (909) 558-2154 | Douglas J Van Putten, MD,FACS 11370 Anderson St # 1800, Loma Linda, CA 92354-3450 Ph: (909) 558-2154 |
Amr Azzam, MD, PHD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 11234 Anderson St, Loma Linda, CA 92350 Phone: 909-558-2182 | |
Dr. Philip Harold Wallar, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 11201 Benton St, Loma Linda, CA 92357 Phone: 909-583-6067 Fax: 999-777-3291 | |
David Sierpina, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 11234 Anderson St, Gme Office Csp 21005, Loma Linda, CA 92354 Phone: 909-558-2154 Fax: 909-558-2180 | |
Priyal Shah, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 11370 Anderson St Ste 1800, Loma Linda, CA 92354 Phone: 909-558-2154 | |
Dr. Ritesh Gupta, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 11370 Anderson St Ste 1800, Loma Linda, CA 92354 Phone: 909-558-2154 Fax: 909-558-2180 | |
Donald E Shearer, M.D. Ophthalmology Medicare: Medicare Enrolled Practice Location: 11346 Mountain View Ave, Ste B, Loma Linda, CA 92354 Phone: 909-796-0101 Fax: 909-796-3035 | |
Jay Kenneth Mattheis, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 11370 Anderson St Ste 1800, Loma Linda, CA 92354 Phone: 909-558-2154 Fax: 909-558-2180 |