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Organization

THE WOMEN'S CLINIC A MEDICAL GROUP OF THE ANTELOPE VALLEY

Active
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Organization

THE WOMEN'S CLINIC A MEDICAL GROUP OF THE ANTELOPE VALLEY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JEANNINE MATA (ACCT MANAGER)
(661) 949-5899
Entity
Organization

Contact information

Practice address
44105 N. 15TH ST W, SUITE 304, LANCASTER, CA 93534
(661) 949-5899
(661) 949-5832
Mailing address
44105 N. 15TH ST W, SUITE 304, LANCASTER, CA 93534
(661) 949-5899
(661) 949-5832

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A380080
—
CA
05
—
00G451540
—
CA
01
—
A88415
DR GUPTA STATE LICENSE
CA
Enumeration date
04/20/2006
Last updated
09/27/2018
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