NPIMap

Organization Active NPI

Faculty Medical Group of Llusm

  • Diagnostic Radiology Physician
  • Loma Linda, CA
National Provider Identifier
1497986228
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
FACULTY MEDICAL GROUP OF LLUSM
Practice address
11370 Anderson St Ste 1700
Loma Linda, CA 92354-3450
Phone
(909) 558-3016
NPI assigned
Jul 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

11370 Anderson St Ste 1700
Loma Linda, CA 92354-3450

Mailing address

File # 54701
Los Angeles, CA 90074-4701
Phone (909) 558-3111

Other names 1

  • FACULTY MEDICAL GROUP OF LLUSM-RADIOLOGY Doing business as

National Provider Directory

National Provider Directory

Locations

11370 Anderson St
Ste 1700
Loma Linda, CA 92354
Phone (909) 558-3016

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1497986228",
    "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": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 1700",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACULTY MEDICAL GROUP OF LLUSM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-28",
        "last_updated": "2010-01-11",
        "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": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FACULTY MEDICAL GROUP OF LLUSM-RADIOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.