Organization
HIGH DESERT PRIMARY CARE
Active
Parent organization
MEDVANTX, INC.
Other names
High Desert Primary Care - Hesperia
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
DANIELLE GREEN (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
17095 MAIN ST, HESPERIA, CA 92345-6004
(760) 948-6606
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A48751
CA
Other
Enumeration date
09/07/2007
Last updated
10/22/2012
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