Provider Demographics
NPI:1922146661
Name:ANTELOPE VALLEY CARDIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:ANTELOPE VALLEY CARDIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAMOD
Authorized Official - Middle Name:V
Authorized Official - Last Name:KADAMBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-674-4222
Mailing Address - Street 1:43723 20TH ST. WEST
Mailing Address - Street 2:STE 101
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534
Mailing Address - Country:US
Mailing Address - Phone:661-674-4222
Mailing Address - Fax:661-674-4220
Practice Address - Street 1:43723 20TH ST. WEST
Practice Address - Street 2:STE 101
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-674-4222
Practice Address - Fax:661-674-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty