FACULTY PHYSICIANS AND SURGEONS OF LLUSM
NPI 1679043400
Family Medicine in Redlands, CA

Q: What is Faculty Physicians And Surgeons Of Llusm's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since December 05, 2018CLIA 05D2346910 · Waiver

25828 REDLANDS BLVD STE 102, REDLANDS, CA 92373(909) 558-6600 Get Directions Write a Review

NPPES record last updated: April 27, 2023. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Jul 19, 2019, Jan 17, 2019, Dec 5, 2018 (3 updates tracked since 2018).

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About Faculty Physicians And Surgeons Of Llusm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI 1679043400) is a healthcare organization registered as a family medicine in Redlands, California and active in the NPI registry since December 2018. The organization holds a CLIA Waiver certificate valid through July 7, 2028, maintains 2 additional practice locations, and lists Ricardo Peverini, President, as its authorized official.

NPPES Registry Identity

NPI1679043400

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameFACULTY PHYSICIANS AND SURGEONS OF LLUSM

Location Address25828 REDLANDS BLVD STE 102Redlands, CA 92373-8450

Mailing AddressFile Number 54701Los Angeles, CA 90074-4701 · (909) 558-4000

Phone(909) 558-6600

Organization SubpartNo

Authorized OfficialRicardo PeveriniPresident · (909) 651-5582

Enumeration DateDecember 5, 2018

Last NPPES UpdateApril 27, 20233 updates tracked since enumeration

NPPES CertifiedApril 27, 2023

✔ NPI 1679043400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

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.

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedPediatricsTaxonomy 208000000X

25828 REDLANDS BLVD STE 102, Redlands, CA 92373

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Secondary Practice Locations 2

Location 125828 Redlands BlvdRedlands, CA 92373-8450 · Phone (909) 558-6600

Location 225828 Redlands Blvd Ste 103Redlands, CA 92373-8451 · Phone (909) 558-6856

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2346910

Faculty Physicians & Surgeons Of Llusm Fam Med 106A · Loma Linda, CA

Active · expires Jul 7, 2028

CLIA Number05D2346910

Laboratory TypePhysician Office

Certificate Effective DateJuly 8, 2026

Certificate Expiration DateJuly 7, 2028

Laboratory DirectorMargarete Ezinwa

Laboratory Phone(909) 558-6600

Laboratory LocationFaculty Physicians & Surgeons Of Llusm Fam Med 106A25455 Barton Rd 106A, Loma Linda, CA 92354

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CALVIN G HAGGLOV M.D.

Family Medicine