# FACULTY PHYSICIANS AND SURGEONS OF LLUSM

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1437109469
- **Authorized official:** RICARDO PEVERINI M.D. (PRESIDENT)
- **Authorized official phone:** (909) 558-7448

## Contact information

- **Practice address:** 11370 ANDERSON ST, SUITE 1800, LOMA LINDA, CA 92354-3450
- **Practice address phone:** (909) 558-2180
- **Mailing address:** FILE NUMBER 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:** 05/11/2006
- **Last updated:** 05/18/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR006902M | — | CA |
| 05 | — | GSD004600 | — | CA |