Faculty Physicians And Surgeons Of Llusm | |
41865 Boardwalk Suite 103 Palm Desert CA 92211-9026 | |
(760) 341-5570 | |
(909) 558-3905 |
Full Name | Faculty Physicians And Surgeons Of Llusm |
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Speciality | Internal Medicine |
Location | 41865 Boardwalk, Palm Desert, California |
Authorized Official Name and Position | Ricardo Peverini (PRESIDENT) |
Authorized Official Contact | 9095587448 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Faculty Physicians And Surgeons Of Llusm File Number 54701 Los Angeles CA 90074-0001 Ph: (909) 558-3111 | Faculty Physicians And Surgeons Of Llusm 41865 Boardwalk Suite 103 Palm Desert CA 92211-9026 Ph: (760) 341-5570 |
NPI Number | 1033169248 |
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Provider Enumeration Date | 05/10/2006 |
Last Update Date | 07/19/2019 |
Identifier | Type | State | Issuer |
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1033169248 | NPI | - | NPPES |
GR006972A | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Jitka Civrna Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74000 Country Club Dr Ste G2, Palm Desert, CA 92260 Phone: 760-773-4948 Fax: 760-773-4910 | |