Active NPI
Faculty Physicians and Surgeons of Llusm
- Cardiovascular Disease Physician
- Loma Linda, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- FACULTY PHYSICIANS AND SURGEONS OF LLUSM
- Practice address
- 11234 Anderson St Ste 1617
Loma Linda, CA 92354-2804 - Phone
- (909) 558-4200
- NPI assigned
- Nov 5, 2008
- Last updated
- Sep 19, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ricardo Peverini, M.D.
- Title
- President
- Phone
- (909) 558-7448
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ph.D. Medical Genetics | 170100000X | |||
| Cardiovascular Disease Physician | 207RC0000X | Primary | ||
| Ph.D. Medical Genetics Physician | 207SG0205X | |||
| Clinical Pathology Physician | 207ZC0006X | |||
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | |||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X |
Addresses
Primary practice location
11234 Anderson St Ste 1617
Loma Linda, CA 92354-2804
Mailing address
File # 54701
Los Angeles, CA 90074-4701
Phone (909) 651-4300
Other practice location 1
11234 Anderson St # 7100
Loma Linda, CA 92354-2804
Phone (909) 558-4200
Other practice location 2
11234 Anderson St # 6200
Loma Linda, CA 92354-2804
Phone (909) 558-4200
Other practice location 3
11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031211000981 | CA | Part B Supplier - Clinic/Group Practice | 1153227814 |
Receives reassigned benefits from 2,632 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryLocations
11234 Anderson St
#7100
Loma Linda, CA 92350
Phone (909) 558-4200
25865 Barton Rd
Loma Linda, CA 92354
2068 Orange Tree Ln
Ste 215
Redlands, CA 92374
Phone (909) 558-4200
Practitioners & affiliated clinicians
Practitioners 67
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.
-
- Internal Medicine Physician
- Loma Linda, CA
- NPI 1285218024
-
- Pediatric Critical Care Medicine Physician
- San Diego, CA
- NPI 1629104492
-
- Neonatal-Perinatal Medicine Physician
- Antioch, CA
- NPI 1962514141
-
- Audiologist
- San Bernardino, CA
- NPI 1407464233
-
- Pediatric Endocrinology Physician
- Irvine, CA
- NPI 1497037915
-
- Infectious Disease Physician
- Loma Linda, CA
- NPI 1750768362
-
- Urology Physician
- Loma Linda, CA
- NPI 1912007816
-
- Pediatric Urology Physician
- Loma Linda, CA
- NPI 1124373329
-
- Anesthesiology Physician
- Arcadia, CA
- NPI 1447382197
-
- Pediatrics Physician
- Loma Linda, CA
- NPI 1902826498
-
- Physician Assistant
- Loma Linda, CA
- NPI 1770192536
-
- Pediatric Cardiology Physician
- Loma Linda, CA
- NPI 1174902548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225843200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695081600000",
"number": "1265686109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE # 54701",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900744701",
"telephone_number": "909-651-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST STE 1617",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804",
"telephone_number": "909-558-4200"
}
],
"practiceLocations": [
{
"address_1": "11234 Anderson St # 7100",
"address_purpose": "LOCATION",
"city": "Loma Linda",
"state": "CA",
"postal_code": "923542804",
"country_code": "US",
"telephone_number": "909-558-4200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11234 Anderson St # 6200",
"address_purpose": "LOCATION",
"city": "Loma Linda",
"state": "CA",
"postal_code": "923542804",
"country_code": "US",
"telephone_number": "909-558-4200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11234 Anderson St",
"address_purpose": "LOCATION",
"city": "Loma Linda",
"state": "CA",
"postal_code": "923542804",
"country_code": "US",
"telephone_number": "909-558-4200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "FACULTY PHYSICIANS AND SURGEONS OF LLUSM",
"organizational_subpart": "NO",
"enumeration_date": "2008-11-05",
"last_updated": "2023-09-19",
"certification_date": "2023-09-19",
"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": "170100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Medical Genetics, Ph.D. Medical Genetics",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
},
{
"code": "207SG0205X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Medical Genetics, Ph.D. Medical Genetics",
"state": null,
"license": null,
"primary": false
},
{
"code": "207ZC0006X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pathology, Clinical Pathology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loma Linda, CA
- 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
- 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
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.