FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1760812192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760812192 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
250 E Caroline St Ste A, B, G San Bernardino CA 92408-3747 |
| Mailing Address |
File # 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9098351810 |
| Practice Fax Number | 9096514586 |
| Mailing Telephone | 9095583111 |
| Mailing Fax Number | 9096514586 |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2019-07-19 |
| 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 | 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 |
250 E CAROLINE ST STE A, B, G |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92408-3747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437125440 | Cheryl P Sanchez-kazi | Pediatrics | 250 E Caroline St, Suite J, San Bernardino, CA 92408-3747 | 2006-02-28 |
| 1952966715 | David G Erickson | Occupational Therapist | 250 E Caroline St, San Bernardino, CA 92408-3747 | 2019-05-07 |
| 1447776661 | Myrna Hana | Pharmacist | 250 E Caroline St, San Bernardino, CA 92408-3747 | 2017-08-18 |
| 1891167029 | Nicole Adams | Nurse Practitioner | 250 E Caroline St, San Bernardino, CA 92408-3747 | 2015-10-27 |
| 1104177849 | Nancy Bravo | Physician Assistant | 250 E Caroline St, Suite A, San Bernardino, CA 92408-3747 | 2012-09-20 |
| 1679861694 | Young Min Kim | Pediatrics | 250 E Caroline St, J West, San Bernardino, CA 92408-3747 | 2011-07-11 |
| 1396079935 | Biswas Joshi | Pediatrics | 250 E Caroline St, Suite J, San Bernardino, CA 92408-3747 | 2009-09-30 |
| 1366465965 | Khiet Ngo | Pediatrics | 250 E Caroline St, Suite J, San Bernardino, CA 92408-3747 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073124681 | Valeria Armentilla Cecena | Student in an Organized Health Care Education/Training Program | 1950 Sunwest Ln., San Bernardino, CA 92408 | 2020-08-17 |
| 1588272066 | Horizon Therapy Services | Physical Therapist | 418 East Vanderbilt, San Bernardino, CA 92408 | 2020-07-21 |
| 1821627639 | Bl Anderson Medical Corporation | Emergency Medicine | 473 E Carnegie Dr., Ste 200, San Bernardino, CA 92408 | 2020-04-03 |
| 1922648104 | Infinite Hope Hospice Corp | Hospice Care, Community Based | 225 W Hospitality Ln Suite 305, San Bernardino, CA 92408 | 2020-01-15 |
| 1689210775 | Inland Empire Community Outreach Center | Counselor | 473 East Carnegie Drive, Suite 200, San Bernardino, CA 92408 | 2019-11-23 |
| 1992347801 | Care Marriage and Family Therapists, Inc. | Marriage & Family Therapist | 1881 Commercenter Drive E, Suite 232, San Bernardino, CA 92408 | 2019-10-11 |
| 1366084360 | Theraville Counseling Services, A Licensed Clinical Social Worker Corp | Social Worker | 155 W Hospitality Ln Ste 245, San Bernardino, CA 92408 | 2019-10-10 |
| 1548730419 | Adriana Alcaraz | Behavior Technician | 473 E Carnegie, Ste 200, San Bernardino, CA 92408 | 2018-12-04 |
| 1811467889 | Xavier J Molina-williams | Behavior Technician | 476 E Carnegie Drive, Ste 200, San Bernardino, CA 92408 | 2018-12-03 |
| 1780153148 | Gillian Washington | Behavior Technician | 473 E Carnegie Dr, Ste 200, Riverside, CA 92408 | 2018-11-15 |
| Find all providers in zip 92408 | ||||
| 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 |
|---|---|---|---|---|
| 1982987095 | Apex Pediatrics Inc | Pediatrics | 399 E Highland Ave Ste 329, San Bernardino, CA 92404-3861 | 2011-09-25 |
| 1639400708 | Roshunda Michelle Coleman | Pediatrics | 190 E. Highland Blvd., San Bernardino, CA 92405-3658 | 2010-01-28 |
| 1124255146 | Angie Bagheri Cook | Pediatrics | 565 N. Mount Vernon Ave, San Bernardino, CA 92411 | 2009-06-17 |
| 1700058526 | Rishikesh S Chavan | Pediatrics | 250 E Caroline St Ste E, San Bernardino, CA 92408-3758 | 2008-04-01 |
| 1346412244 | Matthew Bryan Fong | Pediatrics | 250 S G St, San Bernardino, CA 92410-3320 | 2008-03-31 |
| 1629249859 | Tara Rithaporn Agena | Pediatrics | 565 North Mt Vernon Ave, San Bernardino, CA 92411-2661 | 2008-03-15 |
| 1073795027 | Irene Styadi Tsai | Pediatrics | 685 Carnegie Dr, Ste. #230, San Bernardino, CA 92408-3502 | 2007-12-01 |
| 1235351206 | Edgar Eduardo Alfaro- Mcfield | Pediatrics | 1800 Western Ave Ste 305, San Bernardino, CA 92411-1354 | 2007-05-02 |
| 1659497535 | Alan Irving Lee | Pediatrics | 1906 Commercenter E Ste 101, San Bernardino, CA 92408-3423 | 2007-03-22 |
| 1679612212 | Aena D Han | Pediatrics | 1505 W 17th St Ste 1, San Bernardino, CA 92411-1202 | 2007-02-06 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92408 |
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.