| Heritage Victor Valley Medical Group | |
|
12370 Hesperia Rd Suite 28 Victorville CA 92395-7719 | |
| (714) 456-6966 | |
| (714) 456-8284 |
| Full Name | Heritage Victor Valley Medical Group |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 12370 Hesperia Rd, Victorville, California |
| Authorized Official Name and Position | Manuel Porto (PRESIDENT) |
| Authorized Official Contact | 7144562986 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Victor Valley Medical Group Po Box 54840 Los Angeles CA 90054-0840 Ph: (714) 456-3856 | Heritage Victor Valley Medical Group 12370 Hesperia Rd Suite 28 Victorville CA 92395-7719 Ph: (714) 456-6966 |
| NPI Number | 1902356561 |
|---|---|
| Provider Enumeration Date | 10/07/2016 |
| Last Update Date | 10/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902356561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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