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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 REVERINI MD (PRESIDENT)
(909) 558-7445
Entity
Organization
Contact information
Practice address
69844 HIGHWAY 111, SUITE A & B, RANCHO MIRAGE, CA 92270-2849
(909) 558-3636
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-4701
(909) 558-4000
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
—
NULL
204F00000X
Transplant Surgery Physician
Primary
—
—
Other
Enumeration date
10/22/2013
Last updated
07/19/2019
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