FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1295900439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295900439 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
11370 Anderson St Ste 2050 Loma Linda CA 92354-3450 |
| Mailing Address |
File # 54701 Los Angeles CA 90074-0001 |
| Practice Telephone | 9095583111 |
| Mailing Telephone | 9095583111 |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |
| 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 | 2088P0231X |
Urology Specialization: Pediatric Urology |
Allopathic & Osteopathic Physicians |
| 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 ST STE 2050 |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354-3450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588180236 | Brianna Nicole Stewart | Nurse Practitioner | 11370 Anderson St Ste 2050, Loma Linda, CA 92354-3450 | 2017-08-15 |
| 1124373329 | Catherine J Chen | Urology | 11370 Anderson St Ste 2050, Loma Linda, CA 92354-3450 | 2012-07-13 |
| 1861759102 | Joshua David Chamberlin | Urology | 11370 Anderson St Ste 2050, Loma Linda, CA 92354-3450 | 2012-04-11 |
| 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 | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790326825 | Faculty Physicians and Surgeons of Llusm | Urology | 11360 Mt View Ave Ste B, Loma Linda, CA 92354-3834 | 2019-09-30 |
| 1124373329 | Catherine J Chen | Urology | 11370 Anderson St Ste 2050, Loma Linda, CA 92354-3450 | 2012-07-13 |
| 1861759102 | Joshua David Chamberlin | Urology | 11370 Anderson St Ste 2050, Loma Linda, CA 92354-3450 | 2012-04-11 |
| 1417911710 | Joseph Louis Raffel | Urology | 11370 Anderson Street, Suite 2050, Loma Linda, CA 92354-3450 | 2006-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124416813 | Igal Silber | Urology | 2645 Nido Way, Laguna Beach, CA 92651-4024 | 2015-01-02 |
| 1922430016 | Alan M Freedman M D Inc | Urology | 401 Old Newport Blvd Ste 101, Newport Beach, CA 92663-4276 | 2013-07-31 |
| 1639449614 | Herbert Schwarz | Urology | 12011 Theta Rd, Santa Ana, CA 92705-3328 | 2012-01-06 |
| 1518194935 | Renea Sturm | Urology | 200 Ucla Medical Plz Ste 170, Los Angeles, CA 90095-8344 | 2009-06-11 |
| 1598938243 | Jennifer Hsueh-lin Yang | Urology | Ucsf Department of Urology, 400 Parnassus Avenue, A633, San Francisco, CA 94143-0001 | 2008-04-02 |
| 1386829034 | University Childrens Medical Group | Urology | 4650 W Sunset Blvd # 114, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1255522538 | Andy Yu-how Chang | Urology | 6430 W Sunset Blvd Ste 600, Los Angeles, CA 90028-7909 | 2007-08-05 |
| 1851500573 | Hillary L Copp | Urology | Ucsf Dept of Urology, 400 Parnassus Ave, San Francisco, CA 94143-0001 | 2007-05-21 |
| 1801000542 | Lamia L. Gabal, Md, Inc. | Urology | 720 N Tustin Ave # 140, Santa Ana, CA 92705-3606 | 2007-05-10 |
| 1609963750 | Michael Bertnice Scott | Urology | 3637 Martin Luther King Jr Blvd, Suite B, Lynwood, CA 90262-3511 | 2006-10-09 |
| 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 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.