# ANTELOPE VALLEY NEONATOLOGY GROUP

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

## Provider details

- **NPI number:** 1629691209
- **Authorized official:** DR. MURUGESAMUDALIAR THANGAVEL MD (PARTNER)
- **Authorized official phone:** (661) 400-6577

## Contact information

- **Practice address:** 44155 15TH ST W, LANCASTER, CA 93534-4079
- **Practice address phone:** (661) 949-5366
- **Practice address fax:** (661) 949-5039
- **Mailing address:** 220 STANDIFORD AVE STE F, MODESTO, CA 95350-1159
- **Mailing address phone:** (209) 579-5628
- **Mailing address fax:** (209) 579-5637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/18/2020
- **Last updated:** 03/18/2024