Provider Demographics
NPI:1750589297
Name:ANTELOPE VALLEY HOSPITAL
Entity type:Organization
Organization Name:ANTELOPE VALLEY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-949-5366
Mailing Address - Street 1:1327 LEOPARD CT
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4360
Mailing Address - Country:US
Mailing Address - Phone:661-273-3021
Mailing Address - Fax:
Practice Address - Street 1:44155 15TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4079
Practice Address - Country:US
Practice Address - Phone:661-949-5366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA494712282NW0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NW0100XHospitalsGeneral Acute Care HospitalWomen