Healthcare Provider Details
I. General information
NPI: 1770180382
Provider Name (Legal Business Name): ANTELOPE VALLEY INPATIENT PEDIATRIC ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2020
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 W AVENUE J
LANCASTER CA
93534-2814
US
IV. Provider business mailing address
1748 COUNTRY OAKS LN
THOUSAND OAKS CA
91362-1900
US
V. Phone/Fax
- Phone: 201-956-5124
- Fax:
- Phone: 201-956-5124
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric Gastroenterology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0402X |
| Taxonomy | Neurology with Special Qualifications in Child Neurology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SURAJ
RAJESH
BATISH
Title or Position: CEO
Credential: MD
Phone: 201-956-5124