Organization
VENKAT DEVINENI, MD, INC
Active
Other names
RADIANT HEART INSTITUTE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VENKAT DEVINENI M.D. (OWNER)
(760) 951-7778
Entity
Organization
Contact information
Practice address
17259 JASMINE ST, SUITE B, VICTORVILLE, CA 92395-7787
(760) 951-7778
(760) 951-7760
Mailing address
PO BOX 1537, VICTORVILLE, CA 92393-1537
(760) 951-7778
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A54340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A543400
—
CA
Enumeration date
07/31/2009
Last updated
07/31/2009
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