ANTELOPE VALLEY NEONATOLOGY GROUP (NPI# 1629691209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629691209 |
| Entity Type | Organization |
| Organization Name | ANTELOPE VALLEY NEONATOLOGY GROUP |
| Practice Address |
44155 15th St W Lancaster CA 93534-4079 |
| Mailing Address |
43741 Secure Pl Lancaster CA 93536-5861 |
| Practice Telephone | 6619495366 |
| Practice Fax Number | 6619495039 |
| Mailing Telephone | 6619495366 |
| Mailing Fax Number | 6619495039 |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2020-05-18 |
| Authorized Official Name | DR. MURUGESAMUDALIAR THANGAVEL (PARTNER) |
| Authorized Official Telephone | 6614006577 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL BOARD CALIFORNIA | A117369 | 01 |
| CA | MEDICAL BOARD CALIFORNIA | A34117 | 01 |
| CA | MEDICAL BOARD CALIFORNIA | A134941 | 01 |
| Street Address |
44155 15TH ST W |
| City | LANCASTER |
| State | CA |
| Zip Code | 93534-4079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750589297 | Antelope Valley Hospital | General Acute Care Hospital | 44155 15th St W, Lancaster, CA 93534-4079 | 2007-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194346098 | Lori Ann Barlow Washington | Counselor | 921 W J Street, Lancaster, CA 93534 | 2020-05-01 |
| 1629698253 | Gisela Regalado Paredes | Surgery | Antelope Valley Hospital, 1600 West Ave J, Lancaster, CA 93534 | 2020-04-23 |
| 1124668470 | Latonya Jean Allen | Case Manager/Care Coordinator | 44443 10th St. West, Lancaster, CA 93534 | 2020-01-14 |
| 1629629746 | Korinna Fite | Occupational Therapy Assistant | 43860 10th St. W., Lancaster, CA 93534 | 2019-09-20 |
| 1114576105 | Victor Nemr Hass Md | Anesthesiology | Embassy Surgery Center, 42135 10th Street West 325, Lancaster, CA 93534 | 2019-09-11 |
| 1609421007 | Jaime A Mort | Nurse Practitioner | 43112 N 15st W, Lancaster, CA 93534 | 2019-08-03 |
| 1013560747 | Allyson Lods | Dietitian, Registered | 43115 15th Street West, Lancaster, CA 93534 | 2019-07-22 |
| 1144884123 | Nicole Breanne Palman | Speech-Language Pathologist | 43860 10th St. West, 1st Floor, Lancaster, CA 93534 | 2019-04-25 |
| 1841761475 | Vanessa Gonzalez | Case Manager/Care Coordinator | 44226 10th St West, Lancaster, CA 93534 | 2018-12-07 |
| 1760969265 | Marilyn Joy Pollack | Physical Therapy Assistant | 1306 W Avenue J Ste 2, Lancaster, CA 93534 | 2018-07-26 |
| Find all providers in zip 93534 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417970732 | Ramin Samadi | Pediatrics | 44215 15th St W Ste 305, Lancaster, CA 93534-5505 | 2006-07-26 |
| 1417498999 | Alina Ivashchuk | Pediatrics | 690 Good Dr, Lancaster, PA 17601-2433 | 2017-03-16 |
| 1154449692 | Stephanie Kendra Ardell | Pediatrics | 690 Good Dr, Lancaster, PA 17601 | 2007-03-26 |
| 1821012287 | Murugesamudali Thangavel | Pediatrics | 1600 W Avenue J, Neonatal Intensive Care Unit, Lancaster, CA 93534-2814 | 2006-07-27 |
| 1639190473 | Lancaster General Hospital | Pediatrics | 690 Good Dr, Lancaster, PA 17601-2433 | 2006-07-21 |
| 1306889985 | Joel Warren Secrest | Pediatrics | 690 Good Dr, Lancaster, PA 17601 | 2006-06-13 |
| 1093781247 | Kevin Lorah | Pediatrics | 690 Good Dr, Lancaster, PA 17601-2433 | 2006-02-27 |
| 1730155979 | Stacey Fink | Pediatrics | 690 Good Dr, Lancaster, PA 17601-2433 | 2006-02-27 |
| 1801862057 | Anand Mahajan | Pediatrics | 690 Good Dr, Chca Neonatology @ Lancaster General, Lancaster, PA 17601-2433 | 2006-02-27 |
| 1407822844 | Manjeet Kaur | Pediatrics | 690 Good Dr, Lancaster, PA 17601-2433 | 2006-02-26 |
| Find all providers in LANCASTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.