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Organization
VICTOR VALLEY ANESTHESIA MEDICAL GROUP INC
Active
Organization
VICTOR VALLEY ANESTHESIA MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJENDER S THAKRAN M.D. (MEDICAL DIRECTOR / PRESIDENT)
(760) 242-6561
Entity
Organization
Contact information
Practice address
15248 11TH STREET, VICTORVILLE, CA 92395
(760) 245-8691
(760) 245-8391
Mailing address
14762 KINAI RD, APPLE VALLEY, CA 92307-5120
(760) 242-6561
(760) 242-1354
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A55039
CA
Other
Enumeration date
10/31/2006
Last updated
08/22/2020
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