Desert View Medical

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G60508 Issued in CA

Legal business name

DESERT VIEW MEDICAL

Practice address

205 N 1St St Ste a
Blythe, CA 92225-1777

Phone

(760) 921-3474

Fax

(760) 921-3471

NPI assigned

Nov 1, 2011

Last updated

Aug 5, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kenneth G. Lucero, M.D.NPI 1417079989

Title

President

Phone

(760) 921-3468

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Grant Lucero, M.D.

  • Family Medicine Physician
  • Blythe, CA
  • NPI 1417079989
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1023394285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N 1ST ST STE A",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251777",
            "telephone_number": "760-921-3474",
            "fax_number": "760-921-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N 1ST ST STE A",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251777",
            "telephone_number": "760-921-3474",
            "fax_number": "760-921-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT VIEW MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "LUCERO",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-921-3468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G60508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Christine Defreese
• Ramiro Delgado Jr., BS
• Desert Air Ambulance Inc
• Desert Critical Care Transport, Inc.
• Desert Hills RX LLC (Blythe Mart Pharmacy)
• Dharia DDS Professional Dental Corporation
• David DO, DMD
• Gregory C. Doane, MD
• Frank Wayne Dudley Jr.
• David (None) Dunn, M.D.

• Family Medicine Physician in Blythe, CA
• Providers in Blythe, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.