DESERT VALLEY MEDICAL GROUP, INC. (NPI# 1295031052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295031052 |
| Entity Type | Organization |
| Organization Name | DESERT VALLEY MEDICAL GROUP, INC. |
| Other Organization Name | PRIMECARE MEDICAL GROUP OF DESERT VALLEY, INC. |
| Practice Address |
19181 Town Center Dr Apple Valley CA 92308-8989 |
| Mailing Address |
16850 Bear Valley Rd Victorville CA 92395-5794 |
| Practice Telephone | 7602418000 |
| Practice Fax Number | 7609628021 |
| Mailing Telephone | 7602418000 |
| Mailing Fax Number | 7609628021 |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2020-04-27 |
| Authorized Official Name | DR. KAVITHA BHATIA (OWNER) |
| Authorized Official Telephone | 7602418000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208D00000X | General Practice | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Primecare Medical Group of Desert Valley, Inc. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841804101 | Desert Valley Medical Group, Inc. | Anesthesiology | 11883 Amethyst Rd Ste 202, Victorville, CA 92392-9225 | 2020-09-03 |
| 1912945114 | Desert Valley Medical Group, Inc. | Preventive Medicine | 12401 Hesperia Rd, Victorville, CA 92395-7707 | 2006-06-02 |
| 1639117864 | Desert Valley Medical Group, Inc. | Physical Therapist | 12421 Hesperia Rd, Victorville, CA 92395-7703 | 2006-06-02 |
| 1114973914 | Desert Valley Medical Group, Inc. | Internal Medicine | 17450 Main St, Hesperia, CA 92345-6298 | 2006-05-25 |
| 1063465474 | Desert Valley Medical Group, Inc. | Dietitian, Registered | 16716 Bear Valley Rd, Victorville, CA 92395-5797 | 2006-05-18 |
| 1144272717 | Desert Valley Medical Group, Inc. | Internal Medicine | 14214 Main St, Hesperia, CA 92345-4632 | 2006-05-16 |
| 1942250873 | Desert Valley Medical Group, Inc. | Preventive Medicine | 11499 Bartlett Ave, Adelanto, CA 92301-1902 | 2006-05-11 |
| 1811949548 | Desert Valley Medical Group, Inc. | Family Medicine | 12276 Hesperia Rd, Victorville, CA 92395-5838 | 2006-05-17 |
| 1801848452 | Desert Valley Medical Group, Inc. | Anesthesiology | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2006-05-16 |
| Street Address |
19181 TOWN CENTER DR |
| City | APPLE VALLEY |
| State | CA |
| Zip Code | 92308-8989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144831850 | Lisa K Frandsen | Behavioral Analyst | 19794 Poppy Rd, Apple Valley, CA 92308 | 2020-08-14 |
| 1518484195 | Jennifer Redwine | Behavioral Analyst | 1905 Business Center Drive South, Unit 100, San Bernardino, CA 92308 | 2017-08-24 |
| 1508397100 | West Care Transportation | Non-emergency Medical Transport (VAN) | 15480 Straight Arrow Rd #b, Apple Valley, CA 92308 | 2017-03-24 |
| 1811346497 | E Kim Dental Corp | Dentist | 21580 Bear Valley Rd., Ste B2-2, Apple Valley, CA 92308 | 2016-06-06 |
| 1134575376 | Seth Owuor | Pharmacist | 14426 Palmdale Road, Victorville, CA 92308 | 2016-05-06 |
| 1043608763 | Kamal Ebadpour | Adult Companion | 13224 Iroquois Road, Apple Valley, CA 92308 | 2015-01-05 |
| 1487099669 | Hateem Siddiqui | Internal Medicine | 19059 Bear Valley Rd # 3, Apple Valley, CA 92308 | 2013-05-01 |
| 1225305618 | Edward N. Sianipar | Nurse Practitioner | 19059 Bear Valley Rd., #1, Apple Valley, CA 92308 | 2011-11-29 |
| 1043508559 | Southern California Primary Medical Inc | Clinic/Center | 19341 Bear Valley Rd Ste 101, Apple Valley, CA 92308 | 2011-07-18 |
| 1396070959 | Asghar Ali Rajani | Registered Nurse | 19059 Bear Valley Road, Apple Valley, CA 92308 | 2009-10-14 |
| Find all providers in zip 92308 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760808539 | Hannibal Edwards | General Practice | 19814 Tomahawk Rd, Apple Valley, CA 92307-5054 | 2014-03-17 |
| 1194027854 | Dr Mikel Walk In Clinic | General Practice | 20258 Us Highway 18, Ste 450, Apple Valley, CA 92307-6197 | 2010-11-30 |
| 1336471242 | Sawan Medical Group Inc | General Practice | 16003 Tuscola Rd, Suite H, Apple Valley, CA 92307-0825 | 2010-02-02 |
| 1770810624 | Md Clinic, Inc | General Practice | 14135 Cedar Ave, Apple Valley, MN 55124-4522 | 2009-11-13 |
| 1073569109 | Apple Valley Urgent Care | General Practice | 16003 Tuscola Rd, Suite H, Apple Valley, CA 92307-1319 | 2006-05-26 |
| 1912958786 | Ziad Richard Sawan I | General Practice | 16003 Tuscola Rd, Suite F, Apple Valley, CA 92307-1319 | 2006-05-15 |
| 1396733036 | Nancy Ann Jones | General Practice | 18660 Us Highway 18, Apple Valley, CA 92307-2316 | 2005-10-06 |
| 1427043512 | Fernando J Partida Ruessga | General Practice | 14135 Cedar Ave, Ste 300, Apple Valley, MN 55124-4522 | 2005-09-14 |
| 1417942509 | Md Physicals Inc | General Practice | 14135 Cedar Ave, Ste 300, Apple Valley, MN 55124-4522 | 2005-09-14 |
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| Find all providers with the same taxonomy | ||||
| City | APPLE VALLEY |
| Zip Code | 92308 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.