Victor Valley Neurology, Inc

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A69492 Issued in CA

Legal business name

VICTOR VALLEY NEUROLOGY, INC

Practice address

15995 Tuscola Rd
Suite 203
Apple Valley, CA 92307-2159

Phone

(760) 946-4004

Fax

(760) 946-4944

NPI assigned

Feb 20, 2007

Last updated

Aug 22, 2020By 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

Noel Cuevas Bernales, M.D.NPI 1912049974

Title

President

Phone

(760) 946-4004

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.

• Noel Cuevas Bernales, M.D.

  • Neurology Physician
  • Apple Valley, CA
  • NPI 1912049974
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083759195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15995 TUSCOLA RD",
            "address_2": "SUITE 203",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072159",
            "telephone_number": "760-946-4004",
            "fax_number": "760-946-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15995 TUSCOLA RD",
            "address_2": "SUITE 203",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072159",
            "telephone_number": "760-946-4004",
            "fax_number": "760-946-4944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR VALLEY NEUROLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERNALES",
        "authorized_official_first_name": "NOEL",
        "authorized_official_middle_name": "CUEVAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-946-4004",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A69492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.