Organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Active
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
350 S EUCLID AVE, UNIT C, UPLAND, CA 91786-6665
(909) 558-6388
(909) 651-4586
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-4701
(909) 558-4000
(909) 651-4586
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/25/2015
Last updated
07/19/2019
Update your record
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