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
12021 JACARANDA AVE., HESPERIA, CA 92345-4956
(909) 558-2848
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-4701
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/18/2009
Last updated
12/30/2009
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