Organization
ANTELOPE VALLEY UROLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAWFIK TIM HADAYA M.D. (PRESIDENT)
(661) 949-3006
Entity
Organization
Contact information
Practice address
44105 15TH ST W, SUITE 302, LANCASTER, CA 93534-4088
(661) 949-3006
(661) 949-8770
Mailing address
44105 15TH ST W, SUITE 302, LANCASTER, CA 93534-4088
(661) 949-3006
(661) 949-8770
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A39485
CA
174400000X
Specialist
C39635
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0076830
—
CA
01
—
ZZZ53170Z
BLUE SHIELD
CA
Enumeration date
02/14/2007
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us