# FACULTY PHYSICIANS AND SURGEONS OF LLUSM

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

## Provider details

- **NPI number:** 1679090435
- **Authorized official:** RICARDO PEVERINI MD (PRESIDENT)
- **Authorized official phone:** (909) 558-7448

## Contact information

- **Practice address:** 16100 SAND CANYON AVE STE 220, IRVINE, CA 92618-3729
- **Practice address phone:** (909) 558-3636
- **Mailing address:** FILE NUMBER 54701, LOS ANGELES, CA 90074-4701
- **Mailing address phone:** (909) 558-4000
- **Mailing address fax:** (909) 651-4586

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204F00000X | Transplant Surgery Physician | — | NULL | Yes |
| 204F00000X | Transplant Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/23/2017
- **Last updated:** 07/19/2019