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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