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
Phone: (661) 942-2391
Fax: (661) 902-6839
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710199674 | NPPES |
| California | Other | CMM70633H | MEDI-CAL |
| California | Other | CT556A | MEDI-CAL |
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