FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1710487962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710487962 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
82934 Civic Center Dr Indio CA 92201-4308 |
| Mailing Address |
File Number 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 7604770733 |
| Mailing Telephone | 9096514518 |
| Mailing Fax Number | 9096514586 |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2019-07-19 |
| 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 |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 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 |
82934 CIVIC CENTER DR |
| City | INDIO |
| State | CA |
| Zip Code | 92201-4308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740304211 | Peter Vaccaro | Pediatrics | 82934 Civic Center Dr, Indio, CA 92201-4308 | 2007-03-19 |
| 1831624493 | Sac Health System | Clinic/Center | 82934 Civic Center Dr, Indio, CA 92201-4308 | 2017-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174151534 | Kayla Marie Berry | Licensed Vocational Nurse | Telecare Riverside County Psychiatric Health Facility, Indio, CA 92201 | 2020-03-31 |
| 1699327353 | Nawar Hadid | Dentist | 81735 Ca-111, Indio, CA 92201 | 2019-07-12 |
| 1427521889 | Thanh Trang Thi Nguyen Md Inc | Internal Medicine | 44100 Jefferson St., #e507, Indio, CA 92201 | 2019-01-09 |
| 1306328315 | Grant Nishimura | Dentist | 81-637, Suite 1, Ca-111, Indio, CA 92201 | 2018-09-06 |
| 1700363645 | Desert Physical Medicine | General Practice | 81765 Highway 111, Ste #3, Indio, CA 92201 | 2018-07-24 |
| 1336668151 | U & I Care Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 44105 Jackson St Ste 204, Indio, CA 92201 | 2017-09-13 |
| 1154847234 | Myung Kee Park | Dentist | 81106 Ca-111, #c, Indio, CA 92201 | 2017-08-21 |
| 1912434937 | Mirage Home Health | Home Health | 82691 Miles Ave, Indio, CA 92201 | 2017-05-22 |
| 1497294821 | Orthopedic and Physical Medicine Associates Inc | Chiropractor | 81765 Hwy 111, #3, Indio, CA 92201 | 2017-02-17 |
| 1497103758 | Timothy Smith | Contractor | 81337 Avenida Romero, Indio, CA 92201 | 2016-05-27 |
| Find all providers in zip 92201 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417164070 | Desert Medical Group | Pediatrics | 81880 Doctor Carreon Blvd Ste A103, Indio, CA 92201-5583 | 2007-05-16 |
| 1740304211 | Peter Vaccaro | Pediatrics | 82934 Civic Center Dr, Indio, CA 92201-4308 | 2007-03-19 |
| 1669449773 | M. Nieves Eusebio Gutierrez-go | Pediatrics | 80495 Us Highway 111, Indio, CA 92201-6534 | 2006-03-07 |
| 1336315902 | M. Nieves Gutierrez-go, Md, Inc | Pediatrics | 80495 Us Highway 111, Indio, CA 92201-6534 | 2008-05-05 |
| 1326058348 | Maria Remedios R Gopez | Pediatrics | 81767 Doctor Carreon Blvd, Suite 100, Indio, CA 92201-5509 | 2006-08-09 |
| 1396767919 | Suguna Rs Rao | Pediatrics | 81880 Dr Carreon Blvd, Suite A103, Indio, CA 92201 | 2006-07-24 |
| 1669446118 | Bell Chyur Laiw | Pediatrics | 81709 Dr Carreon Blvd, Ste E-2, Indio, CA 92201 | 2006-02-13 |
| 1629040878 | Chorng Lii Hwang | Pediatrics | 81709 Dr Carreon Blvd, B-2, Indio, CA 92201 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649879099 | Dr Sameh Elamir Md PC | Pediatrics | 1834 W Lincoln Ave Ste R, Anaheim, CA 92801-5425 | 2020-10-17 |
| 1710590971 | Javier R Rios Md, A Professional Corporation | Pediatrics | 6926 Brockton Ave Ste 4&7, Riverside, CA 92506-3800 | 2020-08-27 |
| 1275151342 | California Pediatric & Adolescent Care Inc | Pediatrics | 3340 W Ball Rd Ste A, Anaheim, CA 92804-3729 | 2020-07-06 |
| 1891312153 | Anna Munoz Chavira, Md | Pediatrics | 10603 Horton Ave, Downey, CA 90241-2109 | 2020-07-02 |
| 1699391219 | Margaret Dillon Burchell | Pediatrics | 1524 Columbus Ave, Burlingame, CA 94010-5512 | 2020-06-19 |
| 1780206003 | Pineapple Pediatrics | Pediatrics | 19 E Citrus Ave Ste 201, Redlands, CA 92373-4742 | 2020-05-08 |
| 1497374904 | Ollie Health Medical Group, Inc. | Pediatrics | 9700 Business Park Dr Ste 406, Sacramento, CA 95827-1718 | 2020-04-14 |
| 1790304707 | Nicollette L. Ballou, M.d. | Pediatrics | 3831 Hughes Ave Ste 602, Culver City, CA 90232-6845 | 2020-04-09 |
| 1083243091 | Anita Giselle Wright | Pediatrics | 4003 Clarinda Dr, Tarzana, CA 91356-5048 | 2020-04-02 |
| 1669005500 | Family Choice Pediatrics Inc | Pediatrics | 3801 Katella Ave Ste 221, Los Alamitos, CA 90720-3380 | 2020-02-19 |
| 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.