FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1588034169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588034169 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
350 S Euclid Ave Unit C Upland CA 91786-6665 |
| Mailing Address |
File # 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9095586388 |
| Practice Fax Number | 9096514586 |
| Mailing Telephone | 9095584000 |
| Mailing Fax Number | 9096514586 |
| Enumeration Date | 2015-09-25 |
| 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 |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207T00000X | Neurological Surgery | 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 |
| 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 |
350 S EUCLID AVE UNIT C |
| City | UPLAND |
| State | CA |
| Zip Code | 91786-6665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851519045 | Norman Spencer Merchant | Obstetrics & Gynecology | 350 S Euclid Ave, Suite B, Upland, CA 91786-6665 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093254 | California Clinics, Inc | Physical Medicine & Rehabilitation | 818 N Mountain Ave Ste 102, Upland, CA 91786 | 2019-09-23 |
| 1699231621 | Lynn Keitz | Nurse Practitioner | 360 East 7th Street, Suite D, Upland, CA 91786 | 2019-02-14 |
| 1003386608 | Devin A Lockett | Counselor | 916 N, Mountain Ave. Suite D-1, Upland, CA 91786 | 2018-11-27 |
| 1265900096 | Right Ride | Driver | 1023 West Arrow Hwy Apt A, Upland, CA 91786 | 2018-11-09 |
| 1689142069 | Mike Sedat Safi | Driver | 1023 W Arrow Hwy, Apt A, Upland, CA 91786 | 2018-11-05 |
| 1902373640 | Barsoum Dental | Dentist | 258 E. 9th Street, Upland, CA 91786 | 2018-10-31 |
| 1346736600 | Jennifer Lynn Henshaw | Counselor | Rosewood Counseling Center, 288 W 9th Street, Upland, CA 91786 | 2018-07-10 |
| 1972099521 | Sadeg Aldolaim | Nurse Practitioner | 2086 W Arrow Route, Apt 824, Upland, CA 91786 | 2018-07-06 |
| 1831607332 | Sandra Sun | Pharmacist | 1445 E. Foothill Blvd., Upland, CA 91786 | 2018-01-18 |
| 1841713625 | Dynamic Performance Physical Therapy Inc | Clinic/Center | 2377 W. Foothill Blvd, Ste 20, Upland, CA 91786 | 2017-07-24 |
| Find all providers in zip 91786 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780146019 | Chaparral Medical Group Inc. | Neurological Surgery | 811 E. 11th Street #208 & #207, Upland, CA 91786-4872 | 2019-04-04 |
| 1033499470 | Comprehensive Neurological Sciences, Inc | Neurological Surgery | 999 San Bernardino Road, Upland, CA 91786-4920 | 2011-08-17 |
| 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 |
| 1013524123 | Hubert Tsun-yin Lee | Neurological Surgery | 1201 Welch Road, Stanford, CA 94305-5327 | 2020-09-24 |
| 1811500267 | Chaparral Medical Group, Inc. | Neurological Surgery | 9120 Haven Ave Ste 201, Rancho Cucamonga, CA 91730-5413 | 2020-08-26 |
| 1982259461 | Mauricio Mandel Brigido | Neurological Surgery | 300 Pasteur Dr # R281, Stanford, CA 94305-2200 | 2019-08-01 |
| 1538713227 | Sylvain Palmer Md Inc | Neurological Surgery | 26732 Crown Valley Pkwy Ste 541, Mission Viejo, CA 92691-6376 | 2019-07-31 |
| 1851945877 | X.sean Xin, Do Inc. | Neurological Surgery | 7230 Med Ctr Dr Ste 600, West Hills, CA 91307-4017 | 2019-07-29 |
| 1154974525 | Jan M. Eckermann, Md Inc. | Neurological Surgery | 1617 W Cliff Dr, Ste 203, Newport Beach, CA 92660 | 2019-07-24 |
| 1598317711 | Newport Beach Neurosurgical Institute | Neurological Surgery | 1501 Superior Ave Ste 214b, Newport Beach, CA 92663-3600 | 2019-07-09 |
| 1609438761 | Py26 Neurosurgery, PC | Neurological Surgery | 120 S Spalding Dr Ste 305, Beverly Hills, CA 90212-1800 | 2019-06-28 |
| 1679133664 | Sequoia Neurosurgery, Inc. | Neurological Surgery | 306 N Conyer St Ste A, Visalia, CA 93291-4704 | 2019-06-20 |
| 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.