# FACULTY PHYSICIANS AND SURGEONS OF LLUSM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033361886
- **Authorized official:** RICARDO PEVERINI M.D. (PRESIDENT)
- **Authorized official phone:** (909) 558-7448

## Contact information

- **Practice address:** 4244 RIVERWALK PKWY, STE 100, RIVERSIDE, CA 92505-3372
- **Practice address phone:** (909) 558-2154
- **Mailing address:** FILE \# 54701, LOS ANGELES, CA 90074-0001
- **Mailing address phone:** (909) 558-3111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/10/2008
- **Last updated:** 02/02/2023