Faculty Physicians and Surgeons of Llusm

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

Legal business name

FACULTY PHYSICIANS AND SURGEONS OF LLUSM

Practice address

328 Commercial Rd
Suite 101
San Bernardino, CA 92408-3766

Phone

(909) 558-3111

NPI assigned

May 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ricardo Peverini, MD

Title

President

Phone

(909) 558-7448

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1043260334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE NUMBER 54701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001",
            "telephone_number": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 COMMERCIAL RD",
            "address_2": "SUITE 101",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083766",
            "telephone_number": "909-558-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACULTY PHYSICIANS AND SURGEONS OF LLUSM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "PEVERINI",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-558-7448",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR006902R",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Faculty Physicians and Surgeons of Llusm

• All providers in San Bernardino, CA
• Occupational Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.