FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1932600335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932600335 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
1200 California St Ste 270 Redlands CA 92374-2970 |
| Mailing Address |
File Number 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9095582870 |
| Practice Fax Number | 9096514586 |
| Mailing Telephone | 9095584000 |
| Mailing Fax Number | 9096514586 |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2019-07-22 |
| 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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | 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 |
| 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 |
1200 CALIFORNIA ST STE 270 |
| City | REDLANDS |
| State | CA |
| Zip Code | 92374-2970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053802652 | V Rana Dds Inc | Clinic/Center | 1748 E Lugonia Ave Ste 126, Redlands, CA 92374 | 2018-05-21 |
| 1467979393 | Brianna Ashley Torres | Behavioral Analyst | 1467 Stillman Ave, Redlands, CA 92374 | 2017-08-22 |
| 1851821953 | Veronica Esqueda | Social Worker | 21 Crafton Ct, Redlands, CA 92374 | 2017-06-13 |
| 1053855783 | Caroline Daravi | Psychologist | 1706 Plum Lane #110, Redland, CA 92374 | 2016-12-14 |
| 1487092722 | Kathryn Wheeler | Speech-Language Pathologist | 112 Eleventh Street, Redlands, CA 92374 | 2013-06-10 |
| 1275979254 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 1220 Research Dr, Redlands, CA 92374 | 2013-05-16 |
| 1639515125 | Shantrice Nicole Burton | Speech-Language Pathologist | 1323 W Colton Ave Ste 105, Redlands, CA 92374 | 2013-05-11 |
| 1275898314 | Hrishikesh C Gogineni | Orthopaedic Surgery | 1801 Orange Tree Ln Ste 200, Redlands, CA 92374 | 2012-07-04 |
| 1609168897 | Mina Youssef | Psychiatry & Neurology | 26325 Snowden Ave, Redlands, CA 92374 | 2011-05-06 |
| 1902106545 | Jerrold Edward Hammer | Pharmacist | 422 N Orange St., Redlands, CA 92374 | 2010-10-29 |
| Find all providers in zip 92374 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710340195 | Sherri English | Family Medicine | 25828 Redlands Blvd., Suite 102, Redlands, CA 92373-8450 | 2016-04-01 |
| 1386021145 | Christen Leah Cuevas | Family Medicine | 1200 California St Ste 240, Redlands, CA 92374-2948 | 2015-04-30 |
| 1366710865 | Nathan King | Family Medicine | 1600 E. Citrus Ave, Redlands, CA 92374-4802 | 2011-12-12 |
| 1568758100 | Kauai Nicole Kennedy-eto | Family Medicine | 1711 N. Orange Street, Redlands, CA 92374-2254 | 2011-06-22 |
| 1932400645 | Charles Edward Payton | Family Medicine | 10393 Enterprise Dr, Redlands, CA 92374-4525 | 2010-11-11 |
| 1467650069 | Sophia Alexandros | Family Medicine | 951 Sunset Hills Ln, Redlands, CA 92373-6964 | 2007-07-05 |
| 1588780506 | Benny Hau | Family Medicine | 1244 W Highland Ave, Redlands, CA 92373-6659 | 2007-03-21 |
| 1750467874 | David Fukuda | Family Medicine | 721 Nevada St, Suite #406, Redlands, CA 92373-8079 | 2006-10-31 |
| 1558472464 | Alexander Terrazas | Family Medicine | 1720 Sarrita Dr, Redlands, CA 92373-7222 | 2006-08-31 |
| 1679684807 | Mohammad Moazzan Hossain | Family Medicine | 627 Brookside Ave, Redlands, CA 92373-4666 | 2006-08-31 |
| Find all providers in REDLANDS | ||||
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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.