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
1895 ORANGE TREE LN STE 102, REDLANDS, CA 92374-2822
(909) 558-2824
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
10/21/2008
Last updated
10/17/2022
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