HIGH DESERT MEDICAL CORPORATION (NPI# 1720196702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720196702 |
| Entity Type | Organization |
| Organization Name | HIGH DESERT MEDICAL CORPORATION |
| Other Organization Name | HIGH DESERT MEDICAL GROUP |
| Practice Address |
43839 15th St W Lancaster CA 93534-4756 |
| Mailing Address |
Po Box 7007 Lancaster CA 93539-7007 |
| Practice Telephone | 6619455984 |
| Practice Fax Number | 6619513192 |
| Mailing Telephone | 6619455984 |
| Mailing Fax Number | 6619513192 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2010-03-03 |
| Authorized Official Name | DR. CHARLES MYAING LIM (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6619455984 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE PROVIDER NETWORK, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0047930 | 05 | |
| CA | GR0047931 | 05 |
| Other Name | Type Code |
|---|---|
| HIGH DESERT MEDICAL GROUP | Doing Business As Name - Organization |
| Street Address |
43839 15TH ST W |
| City | LANCASTER |
| State | CA |
| Zip Code | 93534-4756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508860412 | Manuel Arroyo | Family Medicine | 43839 15th St W, Lancaster, CA 93534-4756 | 2005-06-08 |
| 1376143339 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 43839 15th St W, Lancaster, CA 93534-4756 | 2020-10-29 |
| 1992336044 | Dennis Lee Anderson | Social Worker | 43839 15th St W, Lancaster, CA 93534-4756 | 2020-01-28 |
| 1780248492 | Annie Hu | Pharmacist | 43839 15th St W, Lancaster, CA 93534-4756 | 2019-04-28 |
| 1821573981 | Peggy Touche Leugue | Nurse Practitioner | 43839 15th St W, Lancaster, CA 93534-4756 | 2018-09-25 |
| 1427540434 | Kimberly Gill | Nurse Practitioner | 43839 15th St W, Lancaster, CA 93534-4756 | 2018-06-05 |
| 1083148241 | Nancy Le | Pharmacist | 43839 15th St W, Lancaster, CA 93534-4756 | 2017-04-14 |
| 1275996373 | Mike Mckelly | Respiratory Therapist, Certified | 43839 15th St W, Lancaster, CA 93534-4756 | 2016-04-05 |
| 1891153979 | Michelle Moon | Pharmacist | 43839 15th St W, Lancaster, CA 93534-4756 | 2016-02-04 |
| 1700251840 | Irene Hanna | Pharmacist | 43839 15th St W, Lancaster, CA 93534-4756 | 2015-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194346098 | Lori Ann Barlow Washington | Counselor | 921 W J Street, Lancaster, CA 93534 | 2020-05-01 |
| 1629698253 | Gisela Regalado Paredes | Surgery | Antelope Valley Hospital, 1600 West Ave J, Lancaster, CA 93534 | 2020-04-23 |
| 1124668470 | Latonya Jean Allen | Case Manager/Care Coordinator | 44443 10th St. West, Lancaster, CA 93534 | 2020-01-14 |
| 1629629746 | Korinna Fite | Occupational Therapy Assistant | 43860 10th St. W., Lancaster, CA 93534 | 2019-09-20 |
| 1114576105 | Victor Nemr Hass Md | Anesthesiology | Embassy Surgery Center, 42135 10th Street West 325, Lancaster, CA 93534 | 2019-09-11 |
| 1609421007 | Jaime A Mort | Nurse Practitioner | 43112 N 15st W, Lancaster, CA 93534 | 2019-08-03 |
| 1013560747 | Allyson Lods | Dietitian, Registered | 43115 15th Street West, Lancaster, CA 93534 | 2019-07-22 |
| 1144884123 | Nicole Breanne Palman | Speech-Language Pathologist | 43860 10th St. West, 1st Floor, Lancaster, CA 93534 | 2019-04-25 |
| 1841761475 | Vanessa Gonzalez | Case Manager/Care Coordinator | 44226 10th St West, Lancaster, CA 93534 | 2018-12-07 |
| 1760969265 | Marilyn Joy Pollack | Physical Therapy Assistant | 1306 W Avenue J Ste 2, Lancaster, CA 93534 | 2018-07-26 |
| Find all providers in zip 93534 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538263892 | Peter A Hurtubise | Clinic/Center | 1887 Lititz Pike, Suite 6, Lancaster, PA 17601 | 2006-09-08 |
| 1316584907 | Christopher Timothy Pereida | Clinic/Center | 1600 W Avenue J, Lancaster, CA 93534-2814 | 2019-12-03 |
| 1639390339 | Tarzana Treatment Centers, Inc. | Clinic/Center | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2007-05-01 |
| 1205860558 | Frye Chiropractic, Inc | Clinic/Center | 42283 10th St W, Suite 107, Lancaster, CA 93534-7073 | 2006-07-11 |
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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.