ANTELOPE VALLEY COMMUNITY CLINIC - MOBILE HEALTH CLINIC I – NPI #1710199674
Clinic/Center

ANTELOPE VALLEY COMMUNITY CLINIC - MOBILE HEALTH CLINIC I is an AHC clinic located in LANCASTER, CA. NPPES has assigned the NPI number 1710199674 to ANTELOPE VALLEY COMMUNITY CLINIC - MOBILE HEALTH CLINIC I on May 04, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ANTELOPE VALLEY COMMUNITY CLINIC - MOBILE HEALTH CLINIC I” is a dba name, the actual legal business name for this organization is ANTELOPE VALLEY COMMUNITY CLINIC. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 13 years ago on Sep 12, 2013. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ANTELOPE VALLEY COMMUNITY CLINIC - MOBILE HEALTH CLINIC I below.

NPI Profile for
ANTELOPE VALLEY COMMUNITY CLINIC

NPI Number
1710199674
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ANTELOPE VALLEY COMMUNITY CLINIC
Doing Business As (dba): ANTELOPE VALLEY COMMUNITY CLINIC - MOBILE HEALTH CLINIC I
Primary location
45104 10TH ST W
LANCASTER, CA 93534-2310
Phone: (661) 942-2391 Fax: (661) 902-6839
Mailing address
45074 10TH ST W
SUITE 109
LANCASTER, CA 93534-2371
Phone: (661) 942-2391 Fax: (661) 902-6839
Organization Subpart
Yes - ANTELOPE VALLEY COMMUNITY CLINIC - MOBILE HEALTH CLINIC I is subpart of another organization.
Authorized Official
JAMES COOK
CEO
Phone: (661) 942-2391
Updated
Identifiers

Identifiers for ANTELOPE VALLEY COMMUNITY CLINIC - MOBILE HEALTH CLINIC I

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERMEDI-CALCACMM70633H
OTHERMEDICARE PTANCACT556A
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)		 CA 060000428

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.