Provider Demographics
NPI:1720312200
Name:AV MEDICAL BILLER
Entity Type:Organization
Organization Name:AV MEDICAL BILLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-579-9657
Mailing Address - Street 1:1305 HERZEL AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-4380
Mailing Address - Country:US
Mailing Address - Phone:661-579-9657
Mailing Address - Fax:661-579-9565
Practice Address - Street 1:1305 HERZEL AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-4380
Practice Address - Country:US
Practice Address - Phone:661-579-9657
Practice Address - Fax:661-579-9565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24716171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty