Organization
ANTELOPE VALLEY NEONATOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MURUGESAMUDALIAR THANGAVEL MD (PARTNER)
(661) 400-6577
Entity
Organization
Contact information
Practice address
44155 15TH ST W, LANCASTER, CA 93534-4079
(661) 949-5366
(661) 949-5039
Mailing address
220 STANDIFORD AVE STE F, MODESTO, CA 95350-1159
(209) 579-5628
(209) 579-5637
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A117369
MEDICAL BOARD CALIFORNIA
CA
01
—
A134941
MEDICAL BOARD CALIFORNIA
CA
01
—
A34117
MEDICAL BOARD CALIFORNIA
CA
Enumeration date
05/18/2020
Last updated
03/18/2024
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