FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1790326825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790326825 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
11360 Mt View Ave Ste B Loma Linda CA 92354-3834 |
| Mailing Address |
File Number 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9095582830 |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2019-09-30 |
| 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 | 2088P0231X |
Urology Specialization: Pediatric Urology |
Allopathic & Osteopathic Physicians | ||
| Y | 208800000X | Urology | 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 |
| 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 |
11360 MT VIEW AVE STE B |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354-3834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1932725645 | Dev Priya Singhvi | Student in an Organized Health Care Education/Training Program | 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 | 2020-06-18 |
| 1750901278 | Angela N Torres | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-04-24 |
| 1548899230 | Holistic Physical Therapy Inc. | Physical Therapist | 25003 Starr Str, Loma Linda, CA 92354 | 2020-04-03 |
| 1508494071 | Eric Allen | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Pediatrics, General, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-03-31 |
| 1730640244 | Rose Valley Rcfe | Assisted Living Facility | 11574 Poplar St, Loma Linda, CA 92354 | 2019-03-27 |
| 1336633676 | David A Lawrence | Student in an Organized Health Care Education/Training Program | Loma Linda University Hospital, 11234 Anderson St., Loma Linda, CA 92354 | 2018-06-20 |
| 1205329547 | Rachael Nicole Spady | Student in an Organized Health Care Education/Training Program | Loma Linda University Health - Obstetrics & Gynecology, 11234 Anderson St, Loma Linda, CA 92354 | 2018-06-12 |
| 1447756069 | Anthony Ernest Sanchez | Otolaryngology | 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 | 2018-04-03 |
| Find all providers in zip 92354 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841515525 | Roger Li | Urology | 11234 Anderson Street, Gme Office Cp 21005, Loma Linda, CA 92354-2804 | 2010-04-06 |
| 1801023072 | Humberto Guadalupe Villarreal | Urology | 11234 Anderson St Rm A560, Loma Linda, CA 92354-2804 | 2009-06-16 |
| 1407941081 | David Stephen Benjamin | Urology | 11370 Anderson St Ste 1100, Loma Linda, CA 92354-3450 | 2006-10-03 |
| 1215914239 | Mark Thomas Dickinson | Urology | 11370 Anderson Street, Suite 1100, Loma Linda, CA 92354 | 2005-12-30 |
| 1558997452 | Akin Soner Amasyali | Urology | 11234 Anderson St Rm A560, Loma Linda, CA 92354-2804 | 2020-03-23 |
| 1215458237 | Mohammad Hajiha | Urology | 11234 Anderson St Rm A560, Loma Linda, CA 92354-2804 | 2017-06-29 |
| 1871836437 | Milan Shah | Urology | 11370 Anderson St Ste 1100, Loma Linda, CA 92354 | 2013-04-02 |
| 1003073883 | Brian Hu | Urology | 11370 Anderson St Ste 1100, Loma Linda, CA 92354-3450 | 2008-05-20 |
| 1841468774 | Tekisha Urusha Lindler | Urology | 11234 Anderson St, Llumc Cp 21005, Loma Linda, CA 92354 | 2008-02-13 |
| 1093917106 | Lesli Izella Nicolay | Urology | 11370 Anderson St, Suite 2050, Loma Linda, CA 92354-3450 | 2007-06-01 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
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.