NPIMap

Organization Active NPI

Desert Valley Hospital, LLC

Doing business as Desert Valley Hospital

  • General Acute Care Hospital
  • Victorville, CA
National Provider Identifier
1851396576
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
240000562 Issued in CA
Legal business name
DESERT VALLEY HOSPITAL, LLC
Doing business as
Desert Valley Hospital
Practice address
16850 Bear Valley Rd
Attention Hospital Business Office
Victorville, CA 92395-5794
Phone
(760) 241-8000
Fax
(760) 951-2034
NPI assigned
Jun 17, 2005
Last updated
Jan 25, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PRIME HEALTHCARE SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 240000562 CA Primary

Addresses

Primary practice location

16850 Bear Valley Rd
Attention Hospital Business Office
Victorville, CA 92395-5794

Mailing address

16850 Bear Valley Rd
Victorville, CA 92395-5794
Phone (760) 241-8000

Other identifiers 2

IdentifierTypeStateIssuer
HSP30709FMedicaidCA
HSP40709FMedicaidCA

Other names 1

  • Desert Valley Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000347 CA Part A Provider - Hospital 9739081886 Practice locations: Victorville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851396576. Details of each certification follow.

Hospital certification: CCN 050709

Legal name
DESERT VALLEY HOSPITAL LLC
Doing business as
DESERT VALLEY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Sep 19, 1994
Last certification
Oct 1, 2021
Beds
148
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Feb 11, 1992 in CA
Enrollment address
16850 Bear Valley Rd
Victorville, CA 92395-5794
Other Hospital Practice Location
Hospital subgroups
General

Care Compare: Hospital

Medicare Care Compare
Listed as
Desert Valley HospitalCCN 050709 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0643174Desert Valley Hospital16850 Bear Valley Rd, Victorville, CA 92395AccreditationMay 13, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

16850 Bear Valley Rd
Ofc
Victorville, CA 92395

16850 Bear Valley Rd
Ste 105
Victorville, CA 92395

16850 Bear Valley Rd
Ste 206
Victorville, CA 92395

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA Corporation 5% Or Greater Direct Ownership Interest Mar 27, 2000 100%
Other Nov 1, 2007 100%
Dana Roesler Individual Corporate OfficerChief Executive Officer Feb 1, 2022
Corporate DirectorDirector Feb 1, 2022
W-2 Managing EmployeeChief Executive Officer Feb 1, 2022
Luis Leon Individual Corporate OfficerCorporate Chief Executive Officer Jun 1, 2020
Steven Aleman Individual Corporate OfficerChief Financial Officer Jun 1, 2020
Christopher Doan Individual Corporate OfficerChief Compliance Counsel Apr 24, 2017
Prime Healthcare Holdings Inc Organization, Ontario, CA Holding company 5% Or Greater Indirect Ownership Interest Apr 21, 2010 100%

Facilities with the same owner 77

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 77

Practitioners & affiliated clinicians

Practitioners 222

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.

View all 222

Affiliated clinicians 166

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 166

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1851396576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16850 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955794",
            "telephone_number": "760-241-8000",
            "fax_number": "760-951-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16850 BEAR VALLEY RD",
            "address_2": "ATTENTION HOSPITAL BUSINESS OFFICE",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955794",
            "telephone_number": "760-241-8000",
            "fax_number": "760-951-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT VALLEY HOSPITAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME HEALTHCARE SERVICES",
        "enumeration_date": "2005-06-17",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "240000562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP30709F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40709F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Valley Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Desert Valley Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.