FACULTY MEDICAL GROUP OF LLUSM (NPI# 1124259015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124259015 |
| Entity Type | Organization |
| Organization Name | FACULTY MEDICAL GROUP OF LLUSM |
| Other Organization Name | FACULTY MEDICAL GROUP OF LLUSM-RADIOLOGY |
| Practice Address |
900 E Washington St Ste 150 Colton CA 92324-4119 |
| Mailing Address |
File # 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9095583016 |
| Mailing Telephone | 9095583111 |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2009-08-28 |
| Authorized Official Name | RICARDO PEVERINI (PRESIDENT) |
| Authorized Official Telephone | 9095587448 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| FACULTY MEDICAL GROUP OF LLUSM-RADIOLOGY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952626137 | Faculty Medical Group of Llusm | Radiology | 81 Highland Springs Ave Ste 102, Beaumont, CA 92223-3170 | 2010-03-31 |
| 1386875110 | Faculty Medical Group of Llusm | Radiology | 25455 Barton Rd Ste 107b, Loma Linda, CA 92354-3139 | 2009-07-28 |
| 1497986228 | Faculty Medical Group of Llusm | Radiology | 11370 Anderson St Ste 1700, Loma Linda, CA 92354-3450 | 2009-07-28 |
| 1295781219 | Faculty Medical Group of Llusm | Transplant Surgery | 25865 Barton Rd, Ste 101, Loma Linda, CA 92354-3895 | 2006-05-25 |
| 1619314168 | Faculty Medical Group of Llusm | Transplant Surgery | 69844 Highway 111, Suite A & B, Rancho Mirage, CA 92270-2849 | 2013-05-23 |
| 1699071753 | Faculty Medical Group of Llusm | Emergency Medicine | 28078 Baxter Rd, Murrieta, CA 92563 | 2011-02-07 |
| 1659677433 | Faculty Medical Group of Llusm | Emergency Medicine | 28062 Baxter Road, Murrieta, CA 92563 | 2011-01-27 |
| 1295966026 | Faculty Medical Group of Llusm | Radiology | 25333 Barton Rd, Loma Linda, CA 92354-3123 | 2009-07-28 |
| 1942431762 | Faculty Medical Group of Llusm | Radiology | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2009-07-28 |
| 1679704563 | Faculty Medical Group of Llusm | Radiology | 26780 Barton Rd, Redlands, CA 92373-4308 | 2009-07-27 |
| Street Address |
900 E WASHINGTON ST STE 150 |
| City | COLTON |
| State | CA |
| Zip Code | 92324-4119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023265907 | Loma Linda University Radiology Medical Group, Inc | Radiology | 900 E Washington St Ste 150, Colton, CA 92324-4119 | 2008-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739949 | Ava Vascular | Radiology | 1281 W. C. Street, Suite 200, Colton, CA 92324 | 2020-08-06 |
| 1063042851 | Making A Difference Association, Inc. | Psychologist | 1430 E Cooley Drive, Ste 111, Colton, CA 92324 | 2020-01-21 |
| 1326685488 | Allstar Medical Respite and Recuperative Care | Case Management | 450 N Sperry Drive, Colton, CA 92324 | 2019-12-06 |
| 1558916379 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1010 North Pepper Ave, Colton, CA 92324 | 2019-08-08 |
| 1326692633 | Kadi Lyn Pearce | Licensed Practical Nurse | 970 N. Latham St, Colton, CA 92324 | 2019-07-25 |
| 1184281966 | Steven Andrew Cardoza | Physician Assistant | Armc, 400 N. Pepper Ave, Colton, CA 92324 | 2019-05-28 |
| 1528540952 | Daniel Tochukwu Umah-mgborogwu | Physician Assistant | 400 N Pepper Ave, Ste 107, Coton, CA 92324 | 2018-09-01 |
| 1255826038 | Cal Med Vascular Center LLC | Clinic/Center | 1281 W C St, Colton, CA 92324 | 2018-06-25 |
| 1891288072 | A. Arroyo Lourenco Dds, Inc | Dentist | 827 W Valley Blvd., Colton, CA 92324 | 2018-06-12 |
| 1700396165 | Emily Covington | Registered Nurse | 1550 E. Washington St., Ste 101, Colton, CA 92324 | 2017-10-11 |
| Find all providers in zip 92324 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093948069 | Riverside Radiology Medical Group, Inc. | Radiology | 2225 Tiffany Ln, Colton, CA 92324-9246 | 2009-08-25 |
| 1023265907 | Loma Linda University Radiology Medical Group, Inc | Radiology | 900 E Washington St Ste 150, Colton, CA 92324-4119 | 2008-08-22 |
| 1427370444 | James Min Kim | Radiology | 400 N Pepper Ave, Colton, CA 92324-1801 | 2010-02-17 |
| 1013196575 | Michael D Gentry | Radiology | 400 N Pepper Ave, Colton, CA 92324-1819 | 2007-10-31 |
| 1265447106 | Chandler Shyu | Radiology | 400 N Pepper Ave, Dept of Radiology, Colton, CA 92324-1801 | 2006-07-29 |
| 1215965009 | David B. Underwood | Radiology | 400 N Pepper Ave, Colton, CA 92324-1819 | 2006-06-29 |
| 1477591154 | Mark S Girguis | Radiology | 400 N Pepper Ave, Colton, CA 92324-1819 | 2006-06-03 |
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| 1003415613 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38925 Trade Center Dr Unit E, Palmdale, CA 93551-3655 | 2020-10-23 |
| 1083213151 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 44105 15th St W Ste 100, Lancaster, CA 93534-4090 | 2020-10-20 |
| 1750980967 | Centrelake Medical Group Inc | Radiology | 430 W Stetson Ave, Hemet, CA 92543-7328 | 2020-10-19 |
| 1538775994 | Richard J. Moran | Radiology | 230 S Main St Ste 101, Orange, CA 92868-3851 | 2020-09-21 |
| 1417567710 | Family Medical Diagnostics Inc | Radiology | 19231 Victory Blvd Ste 356, Reseda, CA 91335-6308 | 2020-08-03 |
| 1396365011 | Prodiagnose Inc | Radiology | 7345 Topanga Canyon Blvd # 210, Canoga Park, CA 91303-1244 | 2020-04-22 |
| 1548892276 | Alvarado Radiology Group Inc, A Professional Corporation | Radiology | 13700 Marina Pointe Dr Unit 430, Marina Del Rey, CA 90292-9277 | 2020-02-11 |
| 1710518535 | Health Diagnostics of California A Professional Corporation | Radiology | 1690 Barton Rd Ste 107, Redlands, CA 92373-4230 | 2020-01-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.