Organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO PEVERINI MD (PRESIDERN)
(909) 558-7448
Entity
Organization
Contact information
Practice address
615 WEST AVE Q, SUITE E, PALMDALE, CA 93551
(909) 558-3111
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
CA
Other
Enumeration date
11/19/2007
Last updated
07/19/2019
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