FACULTY MEDICAL GROUP OF LLUSM (NPI# 1619314168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619314168 |
| Entity Type | Organization |
| Organization Name | FACULTY MEDICAL GROUP OF LLUSM |
| Practice Address |
69844 Highway 111 Suite A & B Rancho Mirage CA 92270-2849 |
| Mailing Address |
File # 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9095583636 |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2013-05-23 |
| Authorized Official Name | RICARDO PEVERINI (PRESIDENT) |
| 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 | Allopathic & Osteopathic Physicians |
| 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 |
| 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 |
69844 HIGHWAY 111 SUITE A & B |
| City | RANCHO MIRAGE |
| State | CA |
| Zip Code | 92270-2849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730173212 | Aqil P Imam | Allergy & Immunology | 69844 Highway 111, Rancho Mirage, CA 92270-2849 | 2005-09-09 |
| 1750708228 | Shalyce Likens | Marriage & Family Therapist | 69844 Highway 111, Suite H, Rancho Mirage, CA 92270-2849 | 2014-03-24 |
| 1689002024 | Faculty Physicians and Surgeons of Llusm | Transplant Surgery | 69844 Highway 111, Suite A & B, Rancho Mirage, CA 92270-2849 | 2013-10-22 |
| 1437311149 | Total Care Physical Therapy | Physical Therapist | 69844 Highway 111, Ste# D, Rancho Mirage, CA 92270-2849 | 2008-06-25 |
| 1720016470 | Charles George Steffen | Dermatology | 69844 Highway 111, Suite K, Rancho Mirage, CA 92270-2849 | 2006-06-30 |
| 1942268149 | Tsu-yi Chuang | Dermatology | 69844 Highway 111, Suite A, Rancho Mirage, CA 92270-2849 | 2006-05-04 |
| 1487645933 | Desert Medical Group-desert Specialty Group | Internal Medicine | 69844 Highway 111, Rancho Mirage, CA 92270-2849 | 2005-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235757824 | Monsetrrat Martinez | Behavioral Analyst | 69930 Ca-111, Ste 118, Rancho Mirage, CA 92270 | 2020-07-09 |
| 1306475785 | Christine Palmares | Student in an Organized Health Care Education/Training Program | 39000 Bob Hope Drive, Achs-gme Office, Rancho Mirage, CA 92270 | 2020-04-07 |
| 1821627449 | Dino Mellone | Student in an Organized Health Care Education/Training Program | 39000 Bob Hope Drive, Achs-gme Office Ste. 201, Rancho Mirage, CA 92270 | 2020-04-06 |
| 1356970164 | Chris Kim | Student in an Organized Health Care Education/Training Program | Eisenhower Health Emergency Medicine Residency, 39000 Bob Hope Dr., Achs-gme Office, Rancho Mirage, CA 92270 | 2020-04-03 |
| 1609434075 | Junko Ohara | Student in an Organized Health Care Education/Training Program | Eisenhower Health Internal Medicine Residency, 39000 Bob Hope Drive, Achs-gme Office, Rancho Mirage, CA 92270 | 2019-05-31 |
| 1245791896 | Iman Rasheed | Student in an Organized Health Care Education/Training Program | 3900 Bob Hope Drive, Achs-gme Office, Rancho Mirage, CA 92270 | 2019-03-27 |
| 1073086583 | Robert B Greene | Internal Medicine | 8 Moon Lake Drive, Rancho Mirage, CA 92270 | 2019-01-08 |
| 1356818884 | Kade Bartschi | Dentist | 1591 Griffin Rd, 29 Palms, CA 92270 | 2018-11-02 |
| 1841775392 | Rose Pharmacy Rm LLC | Pharmacy | 35400 Bob Hope Drive, Suite #207, Rancho Mirage, CA 92270 | 2018-10-01 |
| 1235615956 | Trang Huyen Nguyen | Dentist | 71-817 Hwy 111 Suite A, Rancho Mirage, CA 92270 | 2018-07-16 |
| Find all providers in zip 92270 | ||||
| Taxonomy Code | 204F00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Transplant Surgery |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689002024 | Faculty Physicians and Surgeons of Llusm | Transplant Surgery | 69844 Highway 111, Suite A & B, Rancho Mirage, CA 92270-2849 | 2013-10-22 |
| 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 | RANCHO MIRAGE |
| Zip Code | 92270 |
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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.