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
25455 BARTON RD STE 209B, LOMA LINDA, CA 92354-3177
(909) 558-6388
(909) 558-3905
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111
(909) 558-3905
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0069021
—
CA
Enumeration date
05/11/2006
Last updated
09/22/2025
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