Victor Valley Primary Care, Inc. | |
16125 Kamana Rd Apple Valley CA 92307-1377 | |
(760) 946-2600 | |
(760) 946-5600 |
Full Name | Victor Valley Primary Care, Inc. |
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Speciality | Clinic/Center |
Location | 16125 Kamana Rd, Apple Valley, California |
Authorized Official Name and Position | Alden I Jallorina (PRESIDENT) |
Authorized Official Contact | 7609462600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Victor Valley Primary Care, Inc. 16125 Kamana Rd Apple Valley CA 92307-1377 Ph: (760) 946-2600 | Victor Valley Primary Care, Inc. 16125 Kamana Rd Apple Valley CA 92307-1377 Ph: (760) 946-2600 |
NPI Number | 1487823985 |
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Provider Enumeration Date | 02/28/2008 |
Last Update Date | 03/23/2020 |
Medicare PECOS PAC ID | 4688726292 |
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Medicare Enrollment ID | O20090713000409 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487823985 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | C52186 (California) | Primary |
Provider Name | Alden Jallorina |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1982611521 PECOS PAC ID: 5799837308 Enrollment ID: I20090713000383 |
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