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Organization

FACULTY PHYSICIANS AND SURGEONS OF LLUSM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICARDO PEVERINI M.D. (PRESIDENT)
(909) 558-7448
Entity
Organization

Contact information

Practice address
28062 BAXTER RD, MURRIETA, CA 92563-1401
(951) 290-4171
(909) 651-4586
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-4701
(909) 558-4000
(909) 558-4586

Taxonomy

Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
207ZC0006X
Clinical Pathology Physician
207ZC0500X
Cytopathology Physician
207ZD0900X
Dermatopathology (Pathology) Physician
207ZF0201X
Forensic Pathology Physician
207ZH0000X
Hematology (Pathology) Physician
207ZI0100X
Immunopathology Physician
207ZM0300X
Medical Microbiology Physician
207ZN0500X
Neuropathology Physician
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
207ZP0101X
Anatomic Pathology Physician
Primary
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
207ZP0104X
Chemical Pathology Physician
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
207ZP0213X
Pediatric Pathology Physician

Other

Enumeration date
01/07/2016
Last updated
07/19/2019
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