Organization
ANTELOPE VALLEY NEPHROLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNG C YANG M.D. (ADMINISTRATOR)
(661) 948-1388
Entity
Organization
Contact information
Practice address
1759 W AVENUE J # 101, LANCASTER, CA 93534-2703
(661) 948-1388
(661) 948-1223
Mailing address
PO BOX 2768, LANCASTER, CA 93539-2768
(661) 948-8309
(661) 948-8907
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
954053663
TAX ID
CA
05
—
GR0002830
—
CA
Enumeration date
07/08/2006
Last updated
02/23/2016
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