1. Home
  2. Directory
  3. California
  4. Loma Linda
  5. Special Hospital
  6. NPI Profile

JERRY L. PETTIS MEMORIAL VA MEDICAL CENTER
NPI 1275691594
Special Hospital in Loma Linda, CA

Active since December 06, 2006
11201 BENTON ST, LOMA LINDA, CA 92357(909) 825-7084 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jerry L. Pettis Memorial Va Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY L. PETTIS MEMORIAL VA MEDICAL CENTER (NPI 1275691594) is a healthcare organization registered as a special hospital in Loma Linda, California and active in the NPI registry since December 2006. The organization lists Dean Stordahl, Medical Center Director, as its authorized official.

NPPES Registry Identity

NPI1275691594
Entity TypeOrganization
Primary Taxonomy284300000X
Legal Business NameJERRY L. PETTIS MEMORIAL VA MEDICAL CENTER
Location Address11201 BENTON STLoma Linda, CA 92357-1000
Mailing Address116 N Plymouth WaySan Bernardino, CA 92408-4116 · (909) 825-7084
Phone(909) 825-7084
Organization SubpartNo
Authorized OfficialDean StordahlMedical Center Director · (909) 825-7084
Enumeration DateDecember 6, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1275691594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecial HospitalHospitals
Taxonomy Code284300000X
License✔ Licensed in LA · G03312
Definition
A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical.
11201 BENTON ST, Loma Linda, CA 92357
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ARTHUR CHUNG-LIUNG CHANG M.D.
Radiology (Diagnostic Radiology)
11201 BENTON ST, VA LOMA LINDA HEALTHCARE SYSTEM - DEPT OF RADIOLOGY
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
JUNGMI LEE LCSW
Social Worker (Clinical)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
PETRU PAPACOSTEA
Internal Medicine
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
PATTY J DALLMEIER RRT
Respiratory Therapist, Registered (Pulmonary Diagnostics)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
PATTY BEAVER LSW
Counselor (Mental Health)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 674-2794
DR. KRYSTAL GREGG PSYD
Psychologist (Clinical)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
HOLLY CORNEJO FNP-C
Nurse Practitioner (Family)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
MELISSA SOLOMON-JACKSON
Registered Nurse (Emergency)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 805-7084

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry L. Pettis Memorial VA Medical Center's NPI number?

The NPI number for Jerry L. Pettis Memorial VA Medical Center is 1275691594. It was assigned to this organization in the NPPES registry on December 6, 2006.

Where is Jerry L. Pettis Memorial VA Medical Center located?

Jerry L. Pettis Memorial VA Medical Center is located at 11201 Benton St, Loma Linda, CA 92357. The listed phone number is (909) 825-7084.

What is Jerry L. Pettis Memorial VA Medical Center's specialty?

The primary specialty registered for this NPI is Special Hospital with taxonomy code 284300000X.

When was this NPI record last updated?

The NPPES record for Jerry L. Pettis Memorial VA Medical Center was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.