Organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO PEVERINI MD (PRESIDENT)
(909) 558-7448
Entity
Organization
Contact information
Practice address
24785 STEWART ST, STE 111, LOMA LINDA, CA 92350-1721
(909) 558-8459
(909) 651-4586
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-4701
(909) 558-4000
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
—
—
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
—
—
2083C0008X
Clinical Informatics Physician
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
—
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2083S0010X
Sports Medicine (Preventive Medicine) Physician
—
—
2083T0002X
Medical Toxicology (Preventive Medicine) Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
Other
Enumeration date
05/02/2017
Last updated
07/19/2019
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