FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1700495363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700495363 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
1850 N Riverside Ave Ste 160 Rialto CA 92376-8056 |
| Mailing Address |
File Number 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9095583016 |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-07-29 |
| 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 | 2085D0003X |
Radiology Specialization: Diagnostic Neuroimaging |
Allopathic & Osteopathic Physicians | ||
| N | 2085H0002X |
Radiology Specialization: Hospice and Palliative Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0205X |
Radiology Specialization: Radiological Physics |
Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
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 |
| 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 |
| 1083863914 | Faculty Physicians and Surgeons of Llusm | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 685 N 13th Ave Ste 11, Upland, CA 91786-4963 | 2008-09-16 |
| 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 |
1850 N RIVERSIDE AVE STE 160 |
| City | RIALTO |
| State | CA |
| Zip Code | 92376-8056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780141812 | Sochun Operation, Inc. | Assisted Living Facility | 1441 S. Riverside Ave., Rialto, CA 92376 | 2019-02-25 |
| 1487138244 | National Vision Inc | Technician/Technologist | 1175 Renaissance Parkway, Suite 1050, Rialto, CA 92376 | 2018-09-18 |
| 1942780853 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 1205 W Renaissance Pkwy, Suite 240, Rialto, CA 92376 | 2018-08-20 |
| 1114430238 | Li Watkins | Nurse Practitioner | 280 N Riverside Avenue, Rialto, CA 92376 | 2017-11-10 |
| 1346767837 | Imelda Jazmin Ceja Nunez | Behavioral Analyst | 462 E Wilson St, Rialto, CA 92376 | 2017-08-24 |
| 1720505662 | Taylor Sandoval | Behavioral Analyst | 2935 Cardamon St, Rialto, CA 92376 | 2017-08-22 |
| 1427572510 | Danielle Mccree | Physical Therapy Assistant | 1470 N Filmore Ave, Rialto, CA 92376 | 2017-07-31 |
| 1639699952 | Albert Anthony Torres | Specialist/Technologist | 1008 N. Pampas Ave., Rialto, CA 92376 | 2017-06-27 |
| 1124407358 | Miesha Warren | Peer Specialist | 850 East Foothill Bld, Rialto, CA 92376 | 2015-05-20 |
| 1205233483 | Albert Archuleta | Counselor | 1501 Riverside Ave, Rialto, CA 92376 | 2014-12-03 |
| Find all providers in zip 92376 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730795881 | Valerie Rondone | Radiology | 2574 Raleigh Way, El Dorado Hills, CA 95762-6973 | 2020-09-23 |
| 1558997387 | Hope & Trust Trading LLC | Radiology | 318 W Colorado St #2, Glendale, CA 91204 | 2020-03-12 |
| 1417416124 | Adventist Health Physicians Network | Radiology | 155 Solano St Ste 101, Corning, CA 96021-3511 | 2019-03-13 |
| 1770068991 | Reham Aboughali | Radiology | 20349 Anza Ave Apt 27, Torrance, CA 90503-7410 | 2018-10-03 |
| 1962910513 | Excel Imaging Center Inc | Radiology | 13071 Brookhurst St Ste 100, Garden Grove, CA 92843-5514 | 2018-01-17 |
| 1467972315 | Radtech Services Inc | Radiology | 2826 Racine St, Simi Valley, CA 93065-2730 | 2017-06-22 |
| 1619363496 | Nathan Ashley | Radiology | 620 N Bonhill Rd, Los Angeles, CA 90049-2302 | 2015-04-08 |
| 1851709984 | Reveal Diagnostics, LLC | Radiology | 6080 Hellyer Ave, Suite 175, San Jose, CA 95138-1052 | 2014-08-01 |
| 1770912784 | William George Hayden | Radiology | 20 Ciervos Rd, Portola Valley, CA 94028-8107 | 2013-11-11 |
| 1215362942 | Reveal Diagnostics LLC | Radiology | 4217 Piedmont Avenue, Suite B, Oakland, CA 94611 | 2013-09-12 |
| Find all providers with the same taxonomy | ||||
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.