Healthcare Provider Details

I. General information

NPI: 1881918407
Provider Name (Legal Business Name): R V DALUVOY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15982 QUANTICO RD STE D
APPLE VALLEY CA
92307-1382
US

IV. Provider business mailing address

15982 QUANTICO RD STE D
APPLE VALLEY CA
92307-1382
US

V. Phone/Fax

Practice location:
  • Phone: 760-810-0920
  • Fax: 760-515-6044
Mailing address:
  • Phone: 760-810-0920
  • Fax: 760-515-6044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberA322690
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: RAO VENKATESWARA DALUVOY
Title or Position: DOCTOR
Credential: MD
Phone: 760-810-0920