NPIMap

Organization Active NPI

Faculty Physicians and Surgeons of Llusm

  • Pediatric Urology Physician
  • Loma Linda, CA
National Provider Identifier
1295900439
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
Legal business name
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Practice address
11370 Anderson St Ste 2050
Loma Linda, CA 92354-3450
Phone
(909) 558-2799
Fax
(909) 558-2704
NPI assigned
Apr 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X
Pediatric Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2088P0231X Primary

Addresses

Primary practice location

11370 Anderson St Ste 2050
Loma Linda, CA 92354-3450

Mailing address

File # 54701
Los Angeles, CA 90074-0001
Phone (909) 558-3111

Other practice location 1

11370 Anderson St # 1100
Loma Linda, CA 92354-3450
Phone (909) 558-2830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Practitioners & affiliated clinicians

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1295900439",
    "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": "900740001",
            "telephone_number": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 2050",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2799",
            "fax_number": "909-558-2704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11370 Anderson St # 1100",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923543450",
            "country_code": "US",
            "telephone_number": "909-558-2830",
            "fax_number": "909-558-2602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FACULTY PHYSICIANS AND SURGEONS OF LLUSM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "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": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; 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.