Faculty Physicians and Surgeons of Llusm

Primary specialty

Transplant Surgery PhysicianTaxonomy code 204F00000X

Legal business name

FACULTY PHYSICIANS AND SURGEONS OF LLUSM

Practice address

1505 Wilson Terrace
Suite 155
Glendale, CA 91206-4071

Phone

(909) 558-3636

NPI assigned

Jan 20, 2015

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 4

Addresses

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": "1421712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1508255175",
    "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",
            "fax_number": "909-651-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WILSON TERRACE",
            "address_2": "SUITE 155",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064071",
            "telephone_number": "909-558-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACULTY PHYSICIANS AND SURGEONS OF LLUSM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-20",
        "last_updated": "2019-07-19",
        "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": "MD"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Transplant Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• F&M Radiology Medical Center Inc
• Farida K. Faal, FNP
• Kareelen Fabian, PTA
• Nicole Antonia Fabris-Carral, M.D.
• Rachel Victoria Facio
• Anthony Faggioli IV, AMFT
• Faith & Life Hospice Inc
• Faith in Action Project
• Jorge Fajardo
• Tracy-Jane Luyun Fajota, AGACNP-BC

• Transplant Surgery Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Transplant Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.