FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1235189275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235189275 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
11370 Anderson Street Suite 3900 Loma Linda CA 92354 |
| Mailing Address |
File Number 54701 Los Angeles CA 90074-0001 |
| Practice Telephone | 9095582806 |
| Practice Fax Number | 9095583905 |
| Mailing Telephone | 9095583111 |
| Mailing Fax Number | 9095583950 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2019-07-19 |
| 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 | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR006902C | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144477 | Faculty Physicians and Surgeons of Llusm | Neurological Surgery | 35400 Bob Hope Dr Ste 110, Rancho Mirage, CA 92270-1772 | 2020-11-04 |
| 1700495363 | Faculty Physicians and Surgeons of Llusm | Radiology | 1850 N Riverside Ave Ste 160, Rialto, CA 92376-8056 | 2020-07-29 |
| 1326665415 | Faculty Physicians and Surgeons of Llusm | Otolaryngology | 4646 Brockton Ave Ste 103, Riverside, CA 92506-0103 | 2020-07-06 |
| 1790326825 | Faculty Physicians and Surgeons of Llusm | Urology | 11360 Mt View Ave Ste B, Loma Linda, CA 92354-3834 | 2019-09-30 |
| 1932600335 | Faculty Physicians and Surgeons of Llusm | Internal Medicine | 1200 California St Ste 270, Redlands, CA 92374-2970 | 2018-02-22 |
| 1386162949 | Faculty Physicians and Surgeons of Llusm | Internal Medicine | 197 E Caroline St, San Bernardino, CA 92408 | 2017-09-05 |
| 1588034169 | Faculty Physicians and Surgeons of Llusm | Physician Assistant | 350 S Euclid Ave, Unit C, Upland, CA 91786-6665 | 2015-09-25 |
| 1912343104 | Faculty Physicians and Surgeons of Llusm | Pediatrics | 1101 N Euclid Ave, Upland, CA 91786-3233 | 2013-05-15 |
| 1457680530 | Faculty Physicians and Surgeons of Llusm | Pediatrics | 12021 Jacaranda Ave., Hesperia, CA 92345-4956 | 2009-12-18 |
| 1265686109 | Faculty Physicians and Surgeons of Llusm | Pathology | 11234 Anderson St Ste 1617, Loma Linda, CA 92354-2804 | 2008-11-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FACULTY PHYSICIANS AND SURGEONS OF LLUSM | 11370 Anderson St, Loma Linda, CA 92354-3450 |
| Street Address |
11370 ANDERSON STREET SUITE 3900 |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215914239 | Mark Thomas Dickinson | Urology | 11370 Anderson Street, Suite 1100, Loma Linda, CA 92354 | 2005-12-30 |
| 1902182421 | Sanaz Amini | Obstetrics & Gynecology | 11370 Anderson Street, Loma Linda, CA 92354 | 2011-10-28 |
| 1578732541 | Aya Eguchi | Internal Medicine | 11370 Anderson Street, Suite 3600, Loma Linda, CA 92354 | 2008-02-25 |
| 1831398700 | Junchan Joshua Yune | Obstetrics & Gynecology | 11370 Anderson Street, Suite 1100, Loma Linda, CA 92354 | 2007-07-12 |
| 1609898758 | Frances Patricia Batin | Specialist | 11370 Anderson Street, Suite 3600, Loma Linda, CA 92354 | 2006-07-24 |
| 1417911710 | Joseph Louis Raffel | Urology | 11370 Anderson Street, Suite 2050, Loma Linda, CA 92354-3450 | 2006-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1932725645 | Dev Priya Singhvi | Student in an Organized Health Care Education/Training Program | 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 | 2020-06-18 |
| 1750901278 | Angela N Torres | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-04-24 |
| 1548899230 | Holistic Physical Therapy Inc. | Physical Therapist | 25003 Starr Str, Loma Linda, CA 92354 | 2020-04-03 |
| 1508494071 | Eric Allen | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Pediatrics, General, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-03-31 |
| 1730640244 | Rose Valley Rcfe | Assisted Living Facility | 11574 Poplar St, Loma Linda, CA 92354 | 2019-03-27 |
| 1336633676 | David A Lawrence | Student in an Organized Health Care Education/Training Program | Loma Linda University Hospital, 11234 Anderson St., Loma Linda, CA 92354 | 2018-06-20 |
| 1205329547 | Rachael Nicole Spady | Student in an Organized Health Care Education/Training Program | Loma Linda University Health - Obstetrics & Gynecology, 11234 Anderson St, Loma Linda, CA 92354 | 2018-06-12 |
| 1447756069 | Anthony Ernest Sanchez | Otolaryngology | 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 | 2018-04-03 |
| Find all providers in zip 92354 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770861767 | Gihan M Bareh | Obstetrics & Gynecology | 11175 Campus Street, Coleman Pavilion #11105, Loma Linda, CA 92354-3901 | 2011-07-26 |
| 1841586419 | Ruofan Yao | Obstetrics & Gynecology | 11234 Anderson St # 3400, Loma Linda, CA 92354-2804 | 2011-06-22 |
| 1437440146 | Courtney Martin | Obstetrics & Gynecology | 11370 Anderson St Ste 3900, Loma Linda, CA 92354 | 2011-04-28 |
| 1285820159 | Thomas E Gibson Jr. | Obstetrics & Gynecology | 11388 Campus St, Loma Linda, CA 92354-3302 | 2007-09-24 |
| 1073704250 | Danielle C.a. Sawyer-macknet | Obstetrics & Gynecology | 25805 Barton Rd, Suite 107, Loma Linda, CA 92354-3814 | 2007-08-05 |
| 1639103260 | James D Rudolf | Obstetrics & Gynecology | 25455 Barton Rd., Suite 212a, Loma Linda, CA 92354-3177 | 2006-07-10 |
| 1578004156 | Michelle Tanzil | Obstetrics & Gynecology | 11175 Campus St, Loma Linda, CA 92350-1700 | 2017-03-15 |
| 1508211368 | Sandy Huynh | Obstetrics & Gynecology | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2016-04-29 |
| 1558749382 | Stephanie Laroche Fegale | Obstetrics & Gynecology | 11370 Anderson St, Loma Linda, CA 92354-3450 | 2015-05-13 |
| 1417334467 | Marissa Caballes | Obstetrics & Gynecology | 11234 Anderson Street, Gme Office Westerly Suite 'c', Loma Linda, CA 92354-2804 | 2015-04-29 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
Please comment or provide details below to improve the information on FACULTY PHYSICIANS AND SURGEONS OF LLUSM.
| 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.