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
11370 ANDERSON ST STE 2050, LOMA LINDA, CA 92354-3450
(909) 558-2799
(909) 558-2704
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
—
—
2088P0231X
Pediatric Urology Physician
Primary
—
—
Other
Enumeration date
04/29/2008
Last updated
02/09/2026
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