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General NPI Number Information
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NPI Number | 1710981733
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Entity Type | Organization
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Legal Business Name | VIR K NANDA MD INC
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 12998 HESPERIA RD STE 204
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City | VICTORVILLE
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State | CA
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Zip | 92395-8317
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Country | US
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Telephone | 760-780-4960
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Fax | 760-780-4964
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Provider Business Mailing Address
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Address Line | 12998 HESPERIA RD STE 204
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City | VICTORVILLE
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State | CA
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Zip | 92395-8317
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Country | US
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Telephone | 760-780-4960
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Fax | 760-780-4964
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIR KUMAR NANDA
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Credential | MD
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Telephone | 760-780-4960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A388830
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A388830
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License Number State | CA
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