| Antelope Valley Community Clinic-palmdale | |
|
2151 E Palmdale Blvd Palmdale CA 93550-4037 | |
| (661) 575-0009 | |
| (661) 575-0015 |
| Full Name | Antelope Valley Community Clinic-palmdale |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2151 E Palmdale Blvd, Palmdale, California |
| Authorized Official Name and Position | James A. Cook (CEO) |
| Authorized Official Contact | 6619422391 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Antelope Valley Community Clinic-palmdale 45074 10th Street West Suite 109 Lancaster CA 93534-2382 Ph: (661) 575-0009 | Antelope Valley Community Clinic-palmdale 2151 E Palmdale Blvd Palmdale CA 93550-4037 Ph: (661) 575-0009 |
| NPI Number | 1346563673 |
|---|---|
| Provider Enumeration Date | 03/01/2010 |
| Last Update Date | 07/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346563673 | NPI | - | NPPES |
| CT556A | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550001129 (California) | Primary |
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