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
11234 ANDERSON ST STE 1617, LOMA LINDA, CA 92354-2804
(909) 558-4200
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-4701
(909) 651-4300
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207SG0205X
Ph.D. Medical Genetics Physician
—
—
207ZC0006X
Clinical Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
11/05/2008
Last updated
09/19/2023
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