NPIMap

Organization Active NPI

Faculty Physicians and Surgeons of Llusm

  • Dermatology Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1831148790
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Practice address
8680 Monroe CT
Suite 250
Rancho Cucamonga, CA 91730-4880
Phone
(909) 558-2890
Fax
(909) 558-3905
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

8680 Monroe CT
Suite 250
Rancho Cucamonga, CA 91730-4880

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Loma Linda University P32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Locations

8680 Monroe Ct
Ste 250
Rch Cucamonga, CA 91730
Phone (909) 558-2890

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1831148790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE NUMBER 54701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001",
            "telephone_number": "909-558-3111",
            "fax_number": "909-558-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8680 MONROE CT",
            "address_2": "SUITE 250",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304880",
            "telephone_number": "909-558-2890",
            "fax_number": "909-558-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACULTY PHYSICIANS AND SURGEONS OF LLUSM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "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": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.