FACULTY MEDICAL GROUP OF LLUSM (NPI# 1295781219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295781219 |
| Entity Type | Organization |
| Organization Name | FACULTY MEDICAL GROUP OF LLUSM |
| Practice Address |
25865 Barton Rd Ste 101 Loma Linda CA 92354-3895 |
| Mailing Address |
File Number 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9095583636 |
| Mailing Telephone | 9095583111 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2009-02-27 |
| Authorized Official Name | RICARDO PEVERINI (PRESIDENT FACULTY MEDICAL GROUP OF) |
| Authorized Official Telephone | 9095587448 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204F00000X | Transplant Surgery | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0068911 | 05 |
| 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 |
| 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 |
| 1124259015 | Faculty Medical Group of Llusm | Radiology | 900 E Washington St Ste 150, Colton, CA 92324-4119 | 2009-07-27 |
| 1679704563 | Faculty Medical Group of Llusm | Radiology | 26780 Barton Rd, Redlands, CA 92373-4308 | 2009-07-27 |
| Street Address |
25865 BARTON RD STE 101 |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354-3895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598205544 | Jennifer Green Nakamura | Social Worker | 25865 Barton Rd, Suite 101, Loma Linda, CA 92354-3895 | 2017-02-23 |
| 1962832998 | Randall Thomas Culler | Physician Assistant | 25865 Barton Rd, Suite 101, Loma Linda, CA 92354-3895 | 2013-11-12 |
| 1700214780 | Faculty Physicians and Surgeons of Llusm | Transplant Surgery | 25865 Barton Rd, Loma Linda, CA 92354-3895 | 2013-10-29 |
| 1720289374 | Mina Oh Rakoski | Internal Medicine | 25865 Barton Rd, Ste 101, Loma Linda, CA 92354-3895 | 2007-05-30 |
| 1366595951 | Jason Tzuying Cheng | Internal Medicine | 25865 Barton Rd, Ste 101, Loma Linda, CA 92354-3895 | 2007-01-19 |
| 1669496832 | Rafael Villicana | Internal Medicine | 25865 Barton Rd, Suite 101, Loma Linda, CA 92354-3895 | 2006-07-27 |
| 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 | 204F00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Transplant Surgery |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982710869 | Charles Fitzgerald Bratton | Transplant Surgery | 25865 Barton Rd Ste 101, Loma Linda, CA 92354-3896 | 2006-08-22 |
| 1700214780 | Faculty Physicians and Surgeons of Llusm | Transplant Surgery | 25865 Barton Rd, Loma Linda, CA 92354-3895 | 2013-10-29 |
| 1376839449 | Jakub Woloszyn | Transplant Surgery | 11175 Campus St, Loma Linda, CA 92350-1700 | 2011-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063829083 | Amit Javed | Transplant Surgery | Ucsf 505 Parnassus Ave M896, Campus Box 0780, San Francisco, CA 94143-0780 | 2014-07-22 |
| 1699039990 | Massimiliano Tuveri | Transplant Surgery | Via Delle Rondini 15, Cagliari, CA 09126 | 2012-07-02 |
| 1457643595 | Neal Martin Mineyev | Transplant Surgery | 2233 Stockton Blvd., Housestaff Building Room 2025, Sacramento, CA 95817 | 2011-05-09 |
| 1790946895 | Ahmad Abou Abbass | Transplant Surgery | 26732 Crown Valley Pkwy Ste 351, Mission Viejo, CA 92691 | 2008-06-20 |
| 1225238538 | Khoa Thomas Anh Pham | Transplant Surgery | 750 Welch Rd Ste 319, Palo Alto, CA 94304-1510 | 2007-07-24 |
| 1356541338 | Raj Mittal | Transplant Surgery | 3400 Lomita Blvd Ste 200, Torrance, CA 90505-4980 | 2007-07-19 |
| 1578760633 | Ayman Al Harakeh | Transplant Surgery | 200 Jose Figueres Ave Ste 225, San Jose, CA 95116 | 2007-06-29 |
| 1063622744 | Ali Cheaito | Transplant Surgery | 11333 N Sepulvelda Blvd, Mission Hills, CA 91345-1116 | 2007-05-23 |
| 1417078882 | Aloke Kumar Mandal | Transplant Surgery | 3110 W Lake Center Dr, Ca152-0243, Santa Ana, CA 92704-6917 | 2007-04-03 |
| 1508909466 | California Pacific Specialty Services | Transplant Surgery | 2302 Fillmore St, Suite A, San Francisco, CA 94115-1813 | 2007-02-14 |
| Find all providers with the same taxonomy | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
Please comment or provide details below to improve the information on FACULTY MEDICAL GROUP 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.