Organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO PEVERINI (PRESIDENT)
(909) 558-7448
Entity
Organization
Contact information
Practice address
685 N 13TH AVE STE 11, UPLAND, CA 91786-4963
(909) 579-6721
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
CA
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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