Faculty Physicians and Surgeons of Llusm
Organization Active NPI Orthopaedic Surgery Physician · Colton, CA
NPI 1669016499 · NPPES record last updated Nov 5, 2019
Key facts
- NPI
- 1669016499
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- FACULTY PHYSICIANS AND SURGEONS OF LLUSM
- Practice address
- 900 E Washington St Ste 200
Colton, CA 92324-4192 - Phone
- (909) 558-4000
- NPI assigned
- Nov 5, 2019
- Organization subpart
- No
Authorized official
- Name
- Ricardo Peverini, MD
- Title
- President
- Phone
- (909) 651-5582
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 5
Practitioners 1,317
-
Cherie Amour Cora, M.D.
-
Theodore K. Gregorius, M.D.
-
Eric Lewis, PT
-
Caroline Mooney, PA-C
-
Scott C Nelson, M.D.
-
Gregory Scott Aaen, M.D.
-
Amir Abdi Pour, MD
-
Ray Roger Abinader, M.D.
-
Ahmed Abou-Zamzam, M.D.
-
Dmitry Abramov, M.D.
-
Shogik Abramyan, M.D.
-
Sara Quraish Abu-Tabikh, M.D.
-
John C Affeldt, MD
-
Sana Afroz, MD
-
John Varujan Agapian, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Totally Kids Rehabilitation Hospital |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jul 1, 2024 Aug 29, 2025 |
Medicare enrollment records
| 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 |
| O20200429002983 | CA | DME Supplier - Physician - Orthopedic/Orthopedic Surgery | 1153227814 | Practice locations: Colton, CA |
National Provider Directory
Locations
25333 Barton Rd
Loma Linda, CA 92350
Phone (909) 558-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes | ||
| Orthopaedic Hand Surgery Physician |
207XS0106X | |||
| Adult Reconstructive Orthopaedic Surgery Physician |
207XS0114X | |||
| Orthopaedic Surgery of the Spine Physician |
207XS0117X | |||
| Orthopaedic Foot and Ankle Surgery Physician |
207XX0004X | |||
| Sports Medicine (Orthopaedic Surgery) Physician |
207XX0005X | |||
| Orthopaedic Trauma Physician |
207XX0801X | |||
| Physical Therapist |
225100000X | |||
| Orthopedic Physical Therapist |
2251X0800X |
Addresses
Primary practice location
900 E Washington St Ste 200
Colton, CA 92324-4192
Mailing address
File Number 54701
Los Angeles, CA 90074-4701
Other providers in Colton, CA
- Executive Medical & Surgical Associates Inc.
- Executive Medical & Surgical Associates Inc.
- Julie O Eze
- Czarina Irish Facer
- Faculty Medical Group of Llusm
- Ambarin Salma Faizi
- Payam Falatoonzadeh
- Peyman Falatoonzadeh
- Family Medicine Faculty Medical Group Inc.
- Mahshid Far
All providers in Colton, CA · Orthopaedic Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.