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HERITAGE VICTOR VALLEY MEDICAL GROUP
NPI 1649506759
Non-Pharmacy Dispensing Site in Victorville, CA

Active since October 23, 2009
12408 HESPERIA RD, #2, VICTORVILLE, CA 92395(760) 245-4747 Get Directions Write a Review

NPPES record last updated: November 30, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Heritage Victor Valley Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HERITAGE VICTOR VALLEY MEDICAL GROUP (NPI 1649506759) is a healthcare organization registered as a non-pharmacy dispensing site in Victorville, California and active in the NPI registry since October 2009. The organization lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1649506759
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameHERITAGE VICTOR VALLEY MEDICAL GROUP
Location Address12408 HESPERIA RD, #2Victorville, CA 92395-7718
Mailing Address9276 Scranton Rd, Suite 100San Diego, CA 92121-7701
Phone(760) 245-4747
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 625-2990
Enumeration DateOctober 23, 2009
Last NPPES UpdateNovember 30, 2015
✔ NPI 1649506759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in CA · 54968
Definition
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.)
12408 HESPERIA RD, Victorville, CA 92395
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Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. BRENT ARTHUR NORTH PA-C
Physician Assistant
12408 HESPERIA RD, SUITE 2
VICTORVILLE, CA 92395
San Bernardino County (760) 553-7000
DR. CURTIS C HOGGARTH O.D.
Optometrist
12408 HESPERIA RD, SUITE 7
VICTORVILLE, CA 92395
San Bernardino County (760) 261-6422
MICHIO ABE MD
Internal Medicine
12408 HESPERIA RD, SUITE 21
VICTORVILLE, CA 92395
San Bernardino County (760) 553-7000
DR. NEAL S. BLANK D.O.
Family Medicine
12408 HESPERIA RD, SUITE 2
VICTORVILLE, CA 92395
San Bernardino County (760) 553-7000
DR. TIFFANY T. TRAN MD
Family Medicine
12408 HESPERIA RD, SUITE 2
VICTORVILLE, CA 92395
San Bernardino County (760) 245-4747
CHRISTOPHER MICHAEL TRAN PA-C
Physician Assistant (Medical)
12408 HESPERIA RD, 2
VICTORVILLE, CA 92395
San Bernardino County (760) 553-7000
DR. PRAKASH K YAKKUNDI MD
Internal Medicine
12408 HESPERIA RD, SUITE 2
VICTORVILLE, CA 92395
San Bernardino County (760) 553-7000
DR. WENDELL E WETTSTEIN MD
General Practice
12408 HESPERIA RD, SUITE 2
VICTORVILLE, CA 92395
San Bernardino County (760) 553-7000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heritage Victor Valley Medical Group's NPI number?

The NPI number for Heritage Victor Valley Medical Group is 1649506759. It was assigned to this organization in the NPPES registry on October 23, 2009.

Where is Heritage Victor Valley Medical Group located?

Heritage Victor Valley Medical Group is located at 12408 Hesperia Rd #2, Victorville, CA 92395. The listed phone number is (760) 245-4747.

What is Heritage Victor Valley Medical Group's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Heritage Victor Valley Medical Group was last updated on November 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.