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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
2071 COMPTON AVE, SUITE 101, CORONA, CA 92881
(909) 558-3111
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-4701
(909) 558-3111

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary

Other

Enumeration date
09/14/2007
Last updated
07/19/2019
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