Provider Demographics
NPI:1295126001
Name:VVIPA MEDICAL GROUP INC
Entity type:Organization
Organization Name:VVIPA MEDICAL GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-726-3819
Mailing Address - Street 1:PO BOX 7020
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-7020
Mailing Address - Country:US
Mailing Address - Phone:661-726-3819
Mailing Address - Fax:661-793-7025
Practice Address - Street 1:12370 HESPERIA RD
Practice Address - Street 2:SUITE 6
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7719
Practice Address - Country:US
Practice Address - Phone:760-245-4747
Practice Address - Fax:760-245-4868
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERITAGE PROVIDER NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-02-16
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty