Organization
ANTELOPE VALLEY IMPOTENCE & INCONTINENCE MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE CLEMENT RAJARATNAIN MD FACS (CEO/UROLOGIST)
(661) 945-0601
Entity
Organization
Contact information
Practice address
38921 TRADE CENTER DR, PALMDALE, CA 93551-3652
(661) 945-0601
(833) 974-2391
Mailing address
38921 TRADE CENTER DR, PALMDALE, CA 93551-3652
(661) 945-0601
(833) 974-2391
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
C042345
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOC423450
—
CA
Enumeration date
09/14/2006
Last updated
01/31/2025
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