Organization
DESERT FAMILY PRACTICE ASSOCIATES MEDICAL GRP INC
Active
Parent organization
DESERT FAMILY PRACTICE ASSOCIATES MEDICAL GROUP INC
Other names
Family Practice Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
DESERT FAMILY PRACTICE ASSOCIATES MEDICAL GROUP INC
Authorized official
MICHAEL C VIZCARRA M.D. (PRESIDENT MEDICAL DIRECTOR)
(760) 948-1454
Entity
Organization
Contact information
Practice address
1301 E MAIN ST, BARSTOW, CA 92311-3219
(760) 256-3864
(760) 256-7378
Mailing address
11919 HESPERIA RD, SUITE A, HESPERIA, CA 92345-1855
(760) 948-1454
(760) 948-6100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G29952
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0050901
—
CA
Enumeration date
03/20/2007
Last updated
08/06/2008
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