Provider Demographics
NPI:1295989226
Name:HIGH DESERT MEDICAL OFFICE
Entity type:Organization
Organization Name:HIGH DESERT MEDICAL OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZIPSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-243-2311
Mailing Address - Street 1:14298 ST. ANDREWS DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395
Mailing Address - Country:US
Mailing Address - Phone:760-243-2311
Mailing Address - Fax:760-243-2880
Practice Address - Street 1:14298 ST. ANDREWS DR
Practice Address - Street 2:SUITE 11
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395
Practice Address - Country:US
Practice Address - Phone:760-243-2311
Practice Address - Fax:760-243-2880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14177111NI0900X
CAG43728111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty