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Organization
ANTELOPE VALLEY SURGICAL ASSOCIATES
Active
Organization
ANTELOPE VALLEY SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAVEL VACLAV PETRIK M.D. (CEO)
(661) 945-4433
Entity
Organization
Contact information
Practice address
1331 W AVENUE J, SUITE 203, LANCASTER, CA 93534-2942
(661) 945-4433
(661) 940-0206
Mailing address
1331 W AVENUE J, SUITE 203, LANCASTER, CA 93534-2942
(661) 945-4433
(661) 940-0206
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
A35504
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G74861
CA
Other
Enumeration date
05/07/2007
Last updated
01/03/2012
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