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Organization
REDLANDS UCC
Active
Organization
REDLANDS UCC
Active
Parent organization
MEDVANTX, INC
Other names
Beaver Medical Group - Redlands Urgent Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC
Authorized official
KENNY HEINE (VP/OPS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
245 TERRACINA BLVD, 102, REDLANDS, CA 92373-4852
(909) 792-2605
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A76937
CA
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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