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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
RICARDO PEVERINI MD (PRESIDENT)
(909) 651-5582
Entity
Organization
Contact information
Practice address
900 E WASHINGTON ST STE 200, COLTON, CA 92324-4192
(909) 558-4000
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-4701
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
NULL
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
NULL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
NULL
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
NULL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
NULL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
NULL
207XX0801X
Orthopaedic Trauma Physician
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
NULL
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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