Desert Vista Anesthesiology Medical Group, Inc.
LBN: Desert Vista Anesthesiology Medical Group, Inc.
Desert Vista Anesthesiology Medical Group, Inc. is an health care organization with primary practice located at 15248 11Th St , Victorville CA 92395-3704. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as the primary health care specialty.
Desert Vista Anesthesiology Medical Group, Inc. can be contacted via phone (760) 245-8691, or through Peterson, Kenneth Percy via phone (805) 796-4595.
Contact Information
Primary practice address
15248 11Th St
Victorville CA 92395-3704
Phone: (760) 245-8691
Fax: (760) 843-6050
Website:
Authorized official contact:
Name: Peterson, Kenneth Percy Doctor of Medicine (MD)
Phone: (805) 796-4595
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X |
Profile Details
| NPI number | 1275674517 |
|---|---|
| LBN Legal business name | Desert Vista Anesthesiology Medical Group, Inc. |
| DBA Doing business as | |
| Authorized official | Peterson, Kenneth Percy Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 9th, 2007 |
| Last updated | Jul 18th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275674517 | NPPES |
| California | Other | ZZZ50059Y | BLUE SHIELD |
| California | MEDICAID | GR0105710 | BLUE SHIELD |
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