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Organization
DESERT VALLEY MEDICAL GROUP, INC.
Active
Organization
DESERT VALLEY MEDICAL GROUP, INC.
Active
Other names
Primecare Medical Group of Desert Valley, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE LANGLEY (IPA ADMINISTRATOR)
(760) 241-8000
Entity
Organization
Contact information
Practice address
12421 HESPERIA RD, VICTORVILLE, CA 92395-7703
(760) 241-8000
Mailing address
16850 BEAR VALLEY RD, VICTORVILLE, CA 92395-5794
(760) 241-8000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4584430009
DMERC
CA
Enumeration date
06/02/2006
Last updated
04/27/2020
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