Organization
ANTELOPE VALLEY NEUROSCIENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDALLAH S FARRUKH MD (PARTNER)
(661) 945-6931
Entity
Organization
Contact information
Practice address
42135 10TH ST W, SUITE 301, LANCASTER, CA 93534-7095
(661) 945-6931
(661) 945-4592
Mailing address
42135 10TH ST W, SUITE 301, LANCASTER, CA 93534-7095
(661) 945-6931
(661) 945-4592
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
2084N0400X
Neurology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
NP20677
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ83620Z
—
CA
Enumeration date
09/16/2005
Last updated
10/07/2014
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