ANTELOPE VALLEY SURGICAL ASSOCIATES NPI 1144433434

NPI Information

  • NPI: 1144433434
  • Provider Name: ANTELOPE VALLEY SURGICAL ASSOCIATES
  • Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
  • Entity Type: Organization
  • Address: 1331 W AVENUE J
    SUITE 203
    LANCASTER, CA
    ZIP 93534
  • Phone: (661) 945-4433

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NPI Details

ANTELOPE VALLEY SURGICAL ASSOCIATES is a thoracic surgery cardiothoracic vascular surgery in Lancaster, CA. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. ANTELOPE VALLEY SURGICAL ASSOCIATES NPI is 1144433434. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1331 W AVENUE J
SUITE 203
LANCASTER, CA
ZIP 93534-942
Phone: (661) 945-4433
Fax: (661) 940-0206

The provider's authorized official is Pavel Vaclav Petrik .
The authorized official title is Ceo and has the following contact phone number (661) 945-4433.

The enumeration date for this NPI number is 5/7/2007 and was last updated on 1/3/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)A35504CALIFORNIANo
2208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)G74861CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GR0091800MEDICAIDCALIFORNIA
2W15432MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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