FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1235189911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235189911 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
25828 Redlands Blvd Ste 101 Redlands CA 92373-8451 |
| Mailing Address |
File Number 54701 Los Angeles CA 90074-0001 |
| Practice Telephone | 9093070964 |
| Mailing Telephone | 9095583111 |
| Mailing Fax Number | 9095583905 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2019-07-19 |
| Authorized Official Name | RICARDO PEVERINI (PRESIDENT) |
| Authorized Official Telephone | 9095587448 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0069024 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 245 Terracina Blvd, Suite 208, Redlands, CA 923734852 | 9097929396 | 9095583905 |
| 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 |
25828 REDLANDS BLVD STE 101 |
| City | REDLANDS |
| State | CA |
| Zip Code | 92373-8451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396269825 | Allana Harboldt | Nurse Practitioner | 25828 Redlands Blvd Ste 101, Redlands, CA 92373-8450 | 2017-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473422 | Mindfulness Counseling Services | Marriage & Family Therapist | 101 E. Redlands, Suite 170a, Redlands, CA 92373 | 2020-09-24 |
| 1710596721 | Vandna Mittal | Counselor | 26967 Beamount Avenue, 1020 Coronado Drive, Redlands, CA 92373 | 2020-07-26 |
| 1164062345 | Sara Bencoe | Nurse Practitioner | 101 E. Redlands Blvd. Ste. 106, Redlands, CA 92373 | 2020-01-15 |
| 1033604103 | John Duane Wuchenich | Anesthesiology | 451 Summit Avenue, Redlands, CA 92373 | 2018-06-29 |
| 1013401074 | Adept Hospice Care | Hospice Care, Community Based | 515 New Jersey St., Suite G, Redlands, CA 92373 | 2018-06-21 |
| 1134616121 | Rodrigo Robles | Student in an Organized Health Care Education/Training Program | 26001 Redlands Blvd ., 2nd Floor, 2d 301, Redlands, CA 92373 | 2018-04-16 |
| 1760987614 | Redlands Endodontics | Dentist | 245 Terracina Blvd Suite 207 B, Redlands, CA 92373 | 2018-03-23 |
| 1487164166 | Tyler Stafford | Behavioral Analyst | 1467 Ford St. Suite 104, Redlands, CA 92373 | 2017-10-06 |
| 1083131486 | Shannon Palmowski | Behavioral Analyst | Institute for Behavioral Health, 1041 Alabama Ave, Redlands, CA 92373 | 2017-08-25 |
| 1275062622 | Erim Sarbuland | Marriage & Family Therapist | 101 East Redlands Boulevard, Suites #215, Redlands, CA 92373 | 2017-06-08 |
| Find all providers in zip 92373 | ||||
| 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 |
|---|---|---|---|---|
| 1780206003 | Pineapple Pediatrics | Pediatrics | 19 E Citrus Ave Ste 201, Redlands, CA 92373-4742 | 2020-05-08 |
| 1952845851 | Mission Pediatrics, Inc. | Pediatrics | 114 W Vine St, Redlands, CA 92373-4762 | 2016-12-12 |
| 1649624537 | Lauren Diatte | Pediatrics | 101 E Redlands Blvd Ste 106, Redlands, CA 92373-4723 | 2016-04-18 |
| 1922494913 | Arshad Jiffry | Pediatrics | 1920 Mesa View Ln, Redlands, CA 92373-6968 | 2015-04-07 |
| 1255657664 | Stephen Weerasit Hamra | Pediatrics | 245 Terracina Blvd Ste 208, Redlands, CA 92373-4851 | 2010-04-09 |
| 1215108006 | Seth Adam Cohen | Pediatrics | 1600 E Citrus Ave Ste A, Redlands, CA 92374-4802 | 2008-03-19 |
| 1528285400 | Maria E. Lois | Pediatrics | 1460 Edgehill Ln, Redlands, CA 92373-6521 | 2007-04-20 |
| 1477508356 | Jorge R Mazlumian | Pediatrics | 1690 Barton Rd Ste 104, Redlands, CA 92373-4230 | 2006-05-23 |
| 1124001888 | Ernesto Cruz | Pediatrics | 1684 Plum Ln, Suite 101, Redlands, CA 92374-4596 | 2005-11-26 |
| 1902369911 | Inland Children's Therapy | Pediatrics | 10431 Commerce St Ste A, Redlands, CA 92374-0110 | 2019-04-08 |
| 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.