HIGH DESERT PRIMARY CARE (NPI# 1205021581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205021581 |
| Entity Type | Organization |
| Organization Name | HIGH DESERT PRIMARY CARE |
| Other Organization Name | HIGH DESERT PRIMARY CARE - VICTORVILLE |
| Practice Address |
12550 Hesperia Rd Victorville CA 92395-5873 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 7602416666 |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2012-10-22 |
| Authorized Official Name | KENNY HEINE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | A53356 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| High Desert Primary Care - Victorville | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508113135 | High Desert Primary Care | Internal Medicine | 17095 Main St, Hesperia, CA 92345-6004 | 2012-08-14 |
| 1619224243 | High Desert Primary Care | Internal Medicine | 19333 Bear Valley Rd, 101, Apple Valley, CA 92308-5148 | 2012-08-14 |
| 1750576344 | High Desert Primary Care | Non-Pharmacy Dispensing Site | 17095 Main St, Hesperia, CA 92345-6004 | 2007-09-07 |
| 1770537466 | High Desert Primary Care | Internal Medicine | 12550 Hesperia Rd, Ste 100, Victorville, CA 92395-5873 | 2006-05-19 |
| Street Address |
12550 HESPERIA RD |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92395-5873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295735413 | Philip Sayler Brown | Pediatrics | 12550 Hesperia Rd, Suite 100, Victorville, CA 92395-5873 | 2005-07-29 |
| 1881934503 | Travis Dean Inglis | Emergency Medicine | 12550 Hesperia Rd, Suite 100, Victorville, CA 92395-5873 | 2013-02-15 |
| 1790053528 | Ricardo M Gomez | Internal Medicine | 12550 Hesperia Rd, Suite 100, Victorville, CA 92395-5873 | 2011-12-07 |
| 1164738522 | High Desert Specialty Group | Specialist | 12550 Hesperia Rd, Suite 100, Victorville, CA 92395-5873 | 2010-08-24 |
| 1023344934 | Lucinda L Carpe | Nurse Practitioner | 12550 Hesperia Rd, Suite 100, Victorville, CA 92395-5873 | 2009-10-28 |
| 1851322002 | Jeremy L Winderweedle | Physician Assistant | 12550 Hesperia Rd, Ste 100, Victorville, CA 92395-5873 | 2006-07-05 |
| 1952357188 | Keith Mark Gross | Dermatology | 12550 Hesperia Rd, 400, Victorville, CA 92395 | 2006-05-26 |
| 1770537466 | High Desert Primary Care | Internal Medicine | 12550 Hesperia Rd, Ste 100, Victorville, CA 92395-5873 | 2006-05-19 |
| 1275582892 | Nelson R Rosales | Family Medicine | 12550 Hesperia Rd, Ste 100, Victorville, CA 92395-0000 | 2006-05-10 |
| 1831148451 | Salwa Fahmi | Family Medicine | 12550 Hesperia Rd, Ste 100, Victorville, CA 92395-5873 | 2006-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1376179093 | Catherine Ward | Speech-Language Pathologist | 13275 Mauka Ct, Victorville, CA 92395 | 2020-03-13 |
| 1174019228 | Laura Mercado Halterman | Family Medicine | 16519 Victor St Ste 307, Victorville, CA 92395 | 2018-07-02 |
| 1306337829 | Stephanie Ann Kruger | Behavior Technician | Sunny Days Inc 3602 Inland Empire Blvd., Ontario, CA 92395 | 2018-05-21 |
| 1861903924 | Debra L Andersen | Clinic/Center | 12830 Hesperia Road, Suite C, D, E, Victorville, CALIFORNIA 92395 | 2017-10-17 |
| 1790202141 | Joshua Powers | Physician Assistant | 12550 Hesperia Rd Ste 101, Victorville, CA 92395 | 2017-08-26 |
| 1043759491 | Kemp Individual & Family Therapy, Inc. | Marriage & Family Therapist | 14075 Hesperia Road, Suite 101, Victorville, CA 92395 | 2017-02-17 |
| 1740725969 | Abem Transportation Inc | Non-emergency Medical Transport (VAN) | 15000 7th St Ste F208, Victorville, CA 92395 | 2016-12-23 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| 1093153215 | Mitesh Patel | Surgery | 13010 Hesperia Rd Ste 400, Victorville, CA 92395 | 2013-06-10 |
| Find all providers in zip 92395 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134506769 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 14544 7th St, Victorville, CA 92395-4214 | 2015-05-04 |
| 1871800961 | Choice Medical Group | Non-Pharmacy Dispensing Site | 13010 Hesperia Rd, 600, Victorville, CA 92395-5837 | 2010-09-10 |
| 1649506759 | Heritage Victor Valley Medical Group | Non-Pharmacy Dispensing Site | 12408 Hesperia Rd, #2, Victorville, CA 92395-7718 | 2009-10-23 |
| 1376685263 | Yvonne Telgt-mckinney, Md Inc. | Non-Pharmacy Dispensing Site | 15366 11th St, O, Victorville, CA 92395-3726 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982225496 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 5757 Pacific Ave Ste 228, Stockton, CA 95207-5159 | 2020-05-06 |
| 1285268391 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 1337 S Lovers Ln Ste D, Visalia, CA 93292-5249 | 2020-02-27 |
| 1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
| 1487210365 | Artius Dermatology Associates P.C. | Non-Pharmacy Dispensing Site | 325 Mall Dr Ste 111, Hanford, CA 93230-5950 | 2019-05-15 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
| Find all providers with the same taxonomy | ||||
| City | VICTORVILLE |
| Zip Code | 92395 |
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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.