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 M.D. (PRESIDENT)
(909) 558-7448
Entity
Organization
Contact information
Practice address
81 HIGHLAND SPRINGS AVE, BEAUMONT, CA 92223-2511
(909) 558-4000
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-0001
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
—
—
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Enumeration date
04/08/2008
Last updated
02/02/2023
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