Faculty Physicians and Surgeons of Llusm

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FACULTY PHYSICIANS AND SURGEONS OF LLUSM

Practice address

104 E Olive Ave
Ste. 100
Redlands, CA 92373-5255

Phone

(909) 792-5197

NPI assigned

May 10, 2006

Last updated

Sep 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ricardo Peverini, M.D.NPI 1275556748

Title

President

Phone

(909) 558-7448

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ricardo Peverini, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Loma Linda, CA
  • NPI 1275556748
  Authorized official Same address or phone

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": "1083664379",
    "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": "104 E OLIVE AVE",
            "address_2": "STE. 100",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735255",
            "telephone_number": "909-792-5197"
        }
    ],
    "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": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0091661",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Excel Physical Therapy and Wellness
• Exordium Medical Group, Inc
• F.H. Banez Dental Corporation
• Tatiana Fabila
• Faculty Medical Group of Llusm (Faculty Medical Group of Llusm-Radiology)
• Faculty Physicians and Surgeons of Llusm
• Faculty Physicians and Surgeons of Llusm
• Faculty Physicians and Surgeons of Llusm
• Faculty Physicians and Surgeons of Llusm
• Faculty Physicians and Surgeons of Llusm

• Dermatology Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Dermatology 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.