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Organization
VENKAT DEVINENI, MD, INC
Active
Organization
VENKAT DEVINENI, MD, INC
Active
Other names
RADIANT HEART INSTITUTE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VENKAT DEVINENI M.D. (OWNER)
(760) 951-7778
Entity
Organization
Contact information
Practice address
17259 JASMINE ST, SUITE B, VICTORVILLE, CA 92395-7787
(760) 951-7778
(760) 951-7760
Mailing address
PO BOX 1537, VICTORVILLE, CA 92393-1537
(760) 951-7778
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A54340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A543400
—
CA
Enumeration date
07/31/2009
Last updated
07/31/2009
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