Organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO PEVERINI MD (PRESIDENT)
(909) 651-5582
Entity
Organization
Contact information
Practice address
1801 N BROADWAY, SANTA ANA, CA 92706-2607
(909) 558-3636
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-4701
(909) 651-4352
(909) 651-4586
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
—
—
207RT0003X
Transplant Hepatology Physician
—
—
2080T0004X
Pediatric Transplant Hepatology Physician
—
—
Other
Enumeration date
07/16/2019
Last updated
07/22/2019
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