Individual
MR. VENKAT DEVINENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17259 JASMINE ST, SUITE B, VICTORVILLE, CA 92395
(760) 951-7778
(760) 241-5950
Mailing address
PO BOX 1537, VICTORVILLE, CA 92393-1537
(760) 951-7778
(760) 241-5950
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A54340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00454301
—
CA
Enumeration date
09/23/2005
Last updated
07/08/2007
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