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
250 S G ST, SAN BERNARDINO, CA 92410-3320
(909) 558-4000
(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
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
06/20/2016
Last updated
07/19/2019
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