# YUCCA VALLEY MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952186322
- **Authorized official:** HEIDI HORNING (CREDENTIALER)
- **Authorized official phone:** (707) 299-7043

## Contact information

- **Practice address:** 57370 29 PALMS HWY STE 203, YUCCA VALLEY, CA 92284-2900
- **Practice address phone:** (760) 369-8200
- **Mailing address:** 57370 29 PALMS HWY STE 203, YUCCA VALLEY, CA 92284-2900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | — | NULL | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 08/25/2023
- **Last updated:** 08/30/2023