# ANTELOPE VALLEY SURGICAL ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144433434
- **Authorized official:** PAVEL VACLAV PETRIK M.D. (CEO)
- **Authorized official phone:** (661) 945-4433

## Contact information

- **Practice address:** 1331 W AVENUE J, SUITE 203, LANCASTER, CA 93534-2942
- **Practice address phone:** (661) 945-4433
- **Practice address fax:** (661) 940-0206
- **Mailing address:** 1331 W AVENUE J, SUITE 203, LANCASTER, CA 93534-2942
- **Mailing address phone:** (661) 945-4433
- **Mailing address fax:** (661) 940-0206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | A35504 | CA | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | G74861 | CA | Yes |

## Other

- **Enumeration date:** 05/07/2007
- **Last updated:** 01/03/2012