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Organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Active
Organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO PEVERINI (PRESIDENT)
(909) 558-7448
Entity
Organization
Contact information
Practice address
685 N 13TH AVE STE 11, UPLAND, CA 91786-4963
(909) 579-6721
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
CA
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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