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Organization
VALLEY HEART PHYSICIAN MEDICAL GROUP, INC.
Active
Organization
VALLEY HEART PHYSICIAN MEDICAL GROUP, INC.
Active
Other names
Valley Heart Center Medical Group Cardiac Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MADHUSUDHAN GUPTA M.D. (OWNER)
(760) 228-1813
Entity
Organization
Contact information
Practice address
58457 29 PALMS HWY STE 200, YUCCA VALLEY, CA 92284-5879
(760) 228-1813
Mailing address
58457 29 PALMS HWY STE 200, YUCCA VALLEY, CA 92284-5879
(760) 228-1813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A65342
CA
207RC0000X
Cardiovascular Disease Physician
A38511
CA
207RC0001X
Clinical Cardiac Electrophysiology Physician
A38511
CA
207RI0011X
Interventional Cardiology Physician
A38511
CA
363LP2300X
Primary Care Nurse Practitioner
NP10511
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0071781
—
CA
01
—
ZZZ52542Z
BLUE SHIELD
CA
Enumeration date
03/19/2008
Last updated
03/19/2008
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