FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1316599640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316599640 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
1801 N Broadway Santa Ana CA 92706-2607 |
| Mailing Address |
File Number 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9095583636 |
| Mailing Telephone | 9096514352 |
| Mailing Fax Number | 9096514586 |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-22 |
| Authorized Official Name | RICARDO PEVERINI (PRESIDENT) |
| Authorized Official Telephone | 9096515582 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080T0004X |
Pediatrics Specialization: Pediatric Transplant Hepatology |
Allopathic & Osteopathic Physicians | ||
| N | 207RT0003X |
Internal Medicine Specialization: Transplant Hepatology |
Allopathic & Osteopathic Physicians | ||
| Y | 204F00000X | Transplant Surgery | 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 |
1801 N BROADWAY |
| City | SANTA ANA |
| State | CA |
| Zip Code | 92706-2607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699786400 | Garo M. Tertzakian | Urology | 1801 N Broadway, Santa Ana, CA 92706-2607 | 2006-08-10 |
| 1871881128 | Associated Urologists of Orange County | Urology | 1801 N Broadway, Santa Ana, CA 92706-2607 | 2011-07-20 |
| 1932306032 | Matthew L Greenberger Md Professional Corporation | Urology | 1801 N Broadway, Santa Ana, CA 92706-2607 | 2007-07-02 |
| 1235336397 | Garo M. Tertzakian, M.d., Inc. | Specialist | 1801 N Broadway, Santa Ana, CA 92706-2607 | 2007-06-29 |
| 1437161668 | Matthew L Greenberger | Urology | 1801 N Broadway, Santa Ana, CA 92706-2607 | 2006-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962972448 | Naijwa Lewis | Counselor | 2100 N. Broadway Suite 101, Santa Ana, CA 92706 | 2018-11-28 |
| 1215428230 | Chances Counseling Centers LLC | Psychologist | 2727 N Bristol St, Santa Ana, CA 92706 | 2018-05-24 |
| 1366962854 | Jankee Pandya | Counselor | 2215 N. Broadway, Ste 200, Santa Ana, CA 92706 | 2017-06-26 |
| 1740719178 | Miriam Alejandro Moreno-ortiz | Counselor | 1910 N. Bush St, Santa Ana, CA 92706 | 2017-06-08 |
| 1942617790 | Janice Botzbach | Behavioral Analyst | 1912 N. Broadway Suite 108, Santa Ana, CA 92706 | 2014-07-14 |
| 1841620689 | Orange County Health Care Agency | Clinic/Center | 550 N. Flower Street, Santa Ana, CA 92706 | 2013-11-14 |
| 1740527274 | Jeremy Nishimoto | Counselor | 2100 N. Broadway Ste 101, Santa Ana, CA 92706 | 2013-01-03 |
| 1326392390 | Rosemary Sara Chesters | Marriage & Family Therapist | 921 West Seventeenth Street, Santa Ana, CA 92706 | 2012-10-30 |
| 1790032019 | Jee Hoon Ha | Dentist | 1313 W 17th St Ste B, Santa Ana, CA 92706 | 2012-08-06 |
| 1437404225 | Lisa Steele | Counselor | 1910 N. Bush, Santa Ana, CA 92706 | 2012-07-17 |
| Find all providers in zip 92706 | ||||
| Taxonomy Code | 204F00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Transplant Surgery |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417078882 | Aloke Kumar Mandal | Transplant Surgery | 3110 W Lake Center Dr, Ca152-0243, Santa Ana, CA 92704-6917 | 2007-04-03 |
| 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 |
| 1508909466 | California Pacific Specialty Services | Transplant Surgery | 2302 Fillmore St, Suite A, San Francisco, CA 94115-1813 | 2007-02-14 |
| 1679612907 | Todd V Brennan | Transplant Surgery | 8900 Beverly Blvd Fl 2, West Hollywood, CA 90048 | 2007-02-05 |
| 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.