FACULTY PHYSICIANS AND SURGEONS OF LLUSM

GLENDALE, CA
NPI1508255175
Entity TypeOrganization
Authorized ContactRICARDO PEVERINI
President
909-558-7448
Organization Subpart ?No
Primary Taxonomy204F00000X Transplant Surgery
Additional Taxonomies235Z00000X Speech-Language Pathologist,
363A00000X Physician Assistant
363L00000X Nurse Practitioner
Enumeration Date2015-01-20
Last Update Date2019-07-19
Business Address
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
1505 WILSON TERRACE SUITE 155
GLENDALE, CA 91206-4071
Phone number: 909-558-3636
Mailing Address
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
FILE # 54701
LOS ANGELES, CA 90074-4701
Phone number: 909-558-3111