Organization
ANTELOPE VALLEY COMMUNITY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES COOK (CHIEF EXECUTIVE OFFICER)
(661) 942-2391
Entity
Organization
Contact information
Practice address
37926 47TH ST E, PALMDALE, CA 93552-3272
(661) 942-2391
Mailing address
45104 10TH ST W, LANCASTER, CA 93534-2310
(661) 942-2391
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CA
Other
Enumeration date
09/30/2016
Last updated
06/01/2017
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