NPIMap

Organization Active NPI

Victor Valley Anesthesia Medical Group Inc

  • Specialist
  • Victorville, CA
National Provider Identifier
1730265679
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A55039 Issued in CA
Legal business name
VICTOR VALLEY ANESTHESIA MEDICAL GROUP INC
Practice address
15248 11TH Street
Victorville, CA 92395
Phone
(760) 245-8691
Fax
(760) 245-8391
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Rajender S Thakran, M.D.NPI 1619988300
Title
Medical Director / President
Phone
(760) 242-6561

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A55039 CA Primary

Addresses

Primary practice location

15248 11TH Street
Victorville, CA 92395

Mailing address

14762 Kinai Rd
Apple Valley, CA 92307-5120
Phone (760) 242-6561

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730265679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14762 KINAI RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923075120",
            "telephone_number": "760-242-6561",
            "fax_number": "760-242-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15248 11TH STREET",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-245-8691",
            "fax_number": "760-245-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR VALLEY ANESTHESIA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THAKRAN",
        "authorized_official_first_name": "RAJENDER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / PRESIDENT",
        "authorized_official_telephone_number": "760-242-6561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A55039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.