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 MD (PRESIDENT)
(909) 558-7448
Entity
Organization
Contact information
Practice address
28078 BAXTER RD, MURRIETA, CA 92563-1400
(909) 558-3111
Mailing address
54701 FILE NUMBER, LOS ANGELES, CA 90074-4701
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0091665
—
CA
Enumeration date
09/20/2006
Last updated
07/19/2019
Update your record
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