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
DR. RICARDO PEVERINI M.D. (PRESIDENT)
(909) 558-7448
Entity
Organization
Contact information
Practice address
2020 WELLNESS WAY, STE 506, LAS VEGAS, NV 89106-4145
(909) 558-3636
(909) 651-4586
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-4701
(909) 558-4000
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
—
—
207RI0008X
Hepatology Physician
—
—
207RT0003X
Transplant Hepatology Physician
—
—
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/07/2016
Last updated
07/19/2019
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