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Organization

HERITAGE VICTOR VALLEY MEDICAL GROUP

Active
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Organization

HERITAGE VICTOR VALLEY MEDICAL GROUP

Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 625-2990
Entity
Organization

Contact information

Practice address
12408 HESPERIA RD, #2, VICTORVILLE, CA 92395-7718
(760) 245-4747
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
54968
CA

Other

Enumeration date
10/23/2009
Last updated
11/30/2015
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