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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
1850 N RIVERSIDE AVE STE 160, RIALTO, CA 92376-8056
(909) 558-3016
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-4701
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
NULL
2085B0100X
Body Imaging Physician
Primary
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
NULL
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085H0002X
Hospice and Palliative Medicine (Radiology) Physician
—
NULL
2085H0002X
Hospice and Palliative Medicine (Radiology) Physician
—
—
2085N0700X
Neuroradiology Physician
—
NULL
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
NULL
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
NULL
2085P0229X
Pediatric Radiology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
NULL
2085R0001X
Radiation Oncology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0203X
Therapeutic Radiology Physician
—
NULL
2085R0203X
Therapeutic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085R0205X
Radiological Physics Physician
—
NULL
2085R0205X
Radiological Physics Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
NULL
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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