ANTELOPE VALLEY NEPHROLOGY MEDICAL GROUP INC. NPI 1336172949

NPI Information

ANTELOPE VALLEY NEPHROLOGY MEDICAL GROUP, INC. is a specialist in Lancaster, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ANTELOPE VALLEY NEPHROLOGY MEDICAL GROUP, INC. NPI is 1336172949. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1759 W AVENUE J # 101
LANCASTER, CA
ZIP 93534-703
Phone: (661) 948-1388
Fax: (661) 948-1223

The provider's authorized official is Sung C Yang .
The authorized official title is Administrator and has the following contact phone number (661) 948-1388.

The CLIA number assigned to this NPI record is 05D0587928 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 2/23/2016.

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:

Other Identifiers

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

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