# ANTELOPE VALLEY COMMUNITY CLINIC

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

## Provider details

- **NPI number:** 1730630427
- **Authorized official:** JAMES COOK (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (661) 942-2391

## Contact information

- **Practice address:** 45124 10TH ST W, LANCASTER, CA 93534-2310
- **Practice address phone:** (661) 942-2391
- **Mailing address:** 45104 10TH ST W, LANCASTER, CA 93534-2310
- **Mailing address phone:** (661) 942-2391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 10016685 | CA | Yes |

## Other

- **Enumeration date:** 10/18/2016
- **Last updated:** 10/18/2016