Antelope Valley Community Clinic - Mobile Health Clinic I

LBN: Antelope Valley Community Clinic
Antelope Valley Community Clinic - Mobile Health Clinic I is an health care organization with primary practice located at 45104 10Th St W , Lancaster CA 93534-2310. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Antelope Valley Community Clinic can be contacted via phone (661) 942-2391, or through Cook, James A. via phone (661) 942-2391.

Contact Information

Primary practice address
45104 10Th St W Lancaster CA 93534-2310
Fax: (661) 902-6839
Website:
Authorized official contact:
Name: Cook, James A. MSW

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 060000428 California

Profile Details

NPI number 1710199674
LBN Legal business name Antelope Valley Community Clinic
DBA Doing business as Antelope Valley Community Clinic - Mobile Health Clinic I
Authorized official Cook, James A. MSW
Entity Organization
Organization subpart 1 Yes
Enumeration date May 4th, 2007
Last updated Sep 12th, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710199674 NPPES
California Other CMM70633H MEDI-CAL
California Other CT556A MEDI-CAL

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