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General NPI Number Information
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NPI Number | 1679879589
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Entity Type | Organization
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Legal Business Name | VICTOR VALLEY HOSPITAL ACQUISITION, INC.
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Dates
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Enumeration Date | 02/10/2011
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 15248 11TH ST
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City | VICTORVILLE
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State | CA
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Zip | 92395-3704
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Country | US
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Telephone | 760-843-6105
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Fax | 760-843-6021
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Provider Business Mailing Address
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Address Line | 15248 11TH ST
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City | VICTORVILLE
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State | CA
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Zip | 92395-3704
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Country | US
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Telephone | 760-843-6105
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Fax | 760-843-6021
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Authorized Official
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Title or Position | SECRETARY
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Name | WILLIAM THOMAS
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Credential |
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Telephone | 951-987-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 240000218
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License Number State | CA
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