HIGH DESERT PRIMARY CARE (NPI# 1750576344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750576344 |
| Entity Type | Organization |
| Organization Name | HIGH DESERT PRIMARY CARE |
| Other Organization Name | HIGH DESERT PRIMARY CARE - HESPERIA |
| Practice Address |
17095 Main St Hesperia CA 92345-6004 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 7609486606 |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2012-10-22 |
| Authorized Official Name | DANIELLE GREEN (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 | A48751 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| High Desert Primary Care - Hesperia | 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 |
| 1205021581 | High Desert Primary Care | Non-Pharmacy Dispensing Site | 12550 Hesperia Rd, Victorville, CA 92395-5873 | 2007-09-11 |
| 1770537466 | High Desert Primary Care | Internal Medicine | 12550 Hesperia Rd, Ste 100, Victorville, CA 92395-5873 | 2006-05-19 |
| Street Address |
17095 MAIN ST |
| City | HESPERIA |
| State | CA |
| Zip Code | 92345-6004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376543785 | Ziad R El-hajjaoui | Internal Medicine | 17095 Main St, Hesperia, CA 92345-6004 | 2005-07-28 |
| 1992210660 | Alice Wang | Physician Assistant | 17095 Main St, Hesperia, CA 92345-6004 | 2017-12-04 |
| 1467985259 | Anastacia Legaspi Rodriguez | Internal Medicine | 17095 Main St, Hesperia, CA 92345-6004 | 2017-04-07 |
| 1215323522 | Wajidah Abdul-khabir | Hospitalist | 17095 Main St, Hesperia, CA 92345-6004 | 2015-04-13 |
| 1508113135 | High Desert Primary Care | Internal Medicine | 17095 Main St, Hesperia, CA 92345-6004 | 2012-08-14 |
| 1194000778 | Kathryn E Stewart | Physician Assistant | 17095 Main St, Hesperia, CA 92345-6004 | 2011-10-14 |
| 1629397914 | Eki S.e. Abrams | Internal Medicine | 17095 Main St, Hesperia, CA 92345-6004 | 2010-05-26 |
| 1447402516 | Asefeh Faraz | Nurse Practitioner | 17095 Main St, Hesperia, CA 92345-6004 | 2008-10-21 |
| 1588828537 | Malini Kethireddy | Family Medicine | 17095 Main St, Hesperia, CA 92345-6004 | 2008-07-17 |
| 1750543427 | James Christiansen | Physical Therapist | 17095 Main St, Hesperia, CA 92345-6004 | 2008-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649881467 | Leslie Guzman | Behavioral Analyst | 6700 Newhall Ave, Hesperia, CA 92345 | 2020-08-14 |
| 1134769896 | Nu Wave Medical Group Inc | Family Medicine | 9390 Hesperia Rd Suite 7, Hesperia, CA 92345 | 2020-01-10 |
| 1760901383 | Lindsey Kathleen Dunnagan | Counselor | 16501 Walnut Street, Suite 12, Hesperia, CA 92345 | 2017-09-14 |
| 1356869374 | Deborah Irene Freeman | Nurse Practitioner | 15398 Main Street Suite A, Hesperia, CA 92345 | 2017-08-30 |
| 1902260151 | Serge Bronstein | Counselor | 16808 Main St., D-154, Hesperia, CA 92345 | 2016-04-13 |
| 1366815805 | Caremore Health Plan | Nurse Practitioner | 17085 Main Street, Hesperia, CA 92345 | 2015-11-05 |
| 1174928402 | Jennifer Cathrin Bayle | Counselor | 17130 Sequoia St, Suite 106, Hesperia, CA 92345 | 2014-10-29 |
| 1447654256 | Diana Grace Chilstrom | Marriage & Family Therapist | 11776 Mariposa Road, Hesperia, CA 92345 | 2014-10-22 |
| 1639597545 | Adrianna Ebony Williams | Physical Therapy Assistant | 8939 11th Ave, Hesperia, CA 92345 | 2014-03-29 |
| 1477974426 | Aja Stoll | Case Manager/Care Coordinator | 9655 Ninth Ave, Hesperia, CA 92345 | 2013-12-18 |
| Find all providers in zip 92345 | ||||
| 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 |
|---|---|---|---|---|
| 1245644160 | One Stop Multi-specialty Medical Group & Therapy, Inc. | Non-Pharmacy Dispensing Site | 10918 Hesperia Rd, Suite B, Hesperia, CA 92345-2151 | 2014-06-18 |
| 1790004513 | One Stop Multi Specialty Medical Group, Inc | Non-Pharmacy Dispensing Site | 10918 Hesperia Rd Ste B, Hesperia, CA 92345-2151 | 2010-05-18 |
| 1801937479 | Eric R. Hansen, D.o., Professional Corporation | Non-Pharmacy Dispensing Site | 15888 Main St, 112b, Hesperia, CA 92345-3452 | 2007-02-08 |
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|---|---|---|---|---|
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| 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 |
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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.