Organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO PEVERINI MD (PRESIDENT)
(909) 651-5582
Entity
Organization
Contact information
Practice address
82934 CIVIC CENTER DR, INDIO, CA 92201-4308
(760) 477-0733
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-4701
(909) 651-4518
(909) 651-4586
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
02/14/2018
Last updated
07/19/2019
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