Organization
A.V. MERIDIEN MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA MANN (ADMINISTRATOR)
(661) 265-7019
Entity
Organization
Contact information
Practice address
1007 WEST AVE M-14, SUITE B-1, PALMDALE, CA 93551
(661) 265-7019
(661) 265-7089
Mailing address
1007 WEST AVE M-14, SUITE B-1, PALMDALE, CA 93551
(661) 265-7019
(661) 265-7089
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A41776
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0071850
—
CA
Enumeration date
10/23/2006
Last updated
11/04/2015
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