# PAVEL V PETRIK MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1598247991
- **Authorized official:** PAVEL V PETRIK MD (CEO)
- **Authorized official phone:** (661) 522-3256

## Contact information

- **Practice address:** 44725 10TH ST W STE 120, LANCASTER, CA 93534-3051
- **Practice address phone:** (661) 522-3256
- **Practice address fax:** (661) 940-0206
- **Mailing address:** PO BOX 8700, LANCASTER, CA 93539-8700
- **Mailing address phone:** (661) 522-3256
- **Mailing address fax:** (661) 940-0206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | A74861 | CA | Yes |

## Other

- **Enumeration date:** 08/31/2018
- **Last updated:** 12/09/2021