Jack Stephen Creagmile, MD
Ophthalmology, Glaucoma Specialist in Loma Linda, CA. Individual provider (NPI-1).
NPI number1659909497
StatusActive
Last updated in NPPESAug 6, 2025
Details
- NPI
- 1659909497
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jack Stephen Creagmile
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 28, 2020
- Certification date
- Aug 6, 2025
- Last updated
- Aug 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207WX0009X | Ophthalmology, Glaucoma Specialist | A193595 | CA | Yes |
| 207W00000X | Ophthalmology | A193595 | CA |
Practice location
11370 Anderson St # 1800Loma Linda, CA 92354-3450
Phone 909-558-2154
Mailing address
11370 Anderson St # 1800Loma Linda, CA 92354-3450
Phone 909-558-2154
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