Faculty Medical Group of Llusm

Primary specialty

Transplant Surgery PhysicianTaxonomy code 204F00000X

Legal business name

FACULTY MEDICAL GROUP OF LLUSM

Practice address

3762 Tibbetts St
Riverside, CA 92506-2605

Phone

(909) 558-3111

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Addresses

Locations

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241481600000",
    "number": "1679625156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54701 FILE NUMBER",
            "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": "3762 TIBBETTS ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062605",
            "telephone_number": "909-558-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACULTY MEDICAL GROUP OF LLUSM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2009-05-05",
        "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": "204F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Transplant Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uju Precious Ezeamama, MD, MSN
• Elizabeth Marie Ezra, RDN
• F & B Healthcare
• Marquita Facen
• Riley Facer
• 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

• Transplant Surgery Physician in Riverside, CA
• Providers in Riverside, 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 May 5, 2009; 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.