Organization
DESERT VALLEY MEDICAL GROUP, INC.
Active
Other names
Primecare Medical Group of Desert Valley, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAVITHA BHATIA MD (OWNER)
(760) 241-8000
Entity
Organization
Contact information
Practice address
12276 HESPERIA RD, VICTORVILLE, CA 92395-5838
(760) 241-8000
Mailing address
16850 BEAR VALLEY RD, VICTORVILLE, CA 92395-5794
(760) 241-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4584430002
DMERC
CA
01
—
CC8406
RAILROAD MEDICARE
—
05
—
GR007209A
—
CA
Enumeration date
05/17/2006
Last updated
04/27/2020
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