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 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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