HERITAGE VICTOR VALLEY MEDICAL GROUP is a non pharmacy dispensing site in Victorville, CA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) HERITAGE VICTOR VALLEY MEDICAL GROUP NPI is 1649506759. The provider is registered as an organization entity type.
The provider's business location address is:
12408 HESPERIA RD
#2
VICTORVILLE, CA
ZIP 92395-718
Phone: (760) 245-4747
The provider's authorized official is Kenny Heine .
The authorized official title is Vp Of Operations and has the following contact phone number (858) 625-2990.
The CLIA number assigned to this NPI record is 05D2030527 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 10/23/2009 and was last updated on 11/30/2015.