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
11234 ANDERSON ST, LOMA LINDA, CA 92350-1716
(909) 558-4000
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-4701
(909) 651-4300
(909) 651-4586
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0069023
—
CA
Enumeration date
05/11/2006
Last updated
01/07/2026
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