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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 M.D. (PRESIDENT)
(909) 558-7448
Entity
Organization
Contact information
Practice address
11406 LOMA LINDA DR STE 300, LOMA LINDA, CA 92354-3711
(909) 558-6277
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
NULL
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GAC000270
—
CA
Enumeration date
03/13/2009
Last updated
03/13/2009
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